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Donor-site lymphatic function after microvascular lymph node transfer
Tiina P Viitanen1, Maija T Mäki, Marko P Seppänen
1Turku, Finland From Plastic Surgery and the Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, and Turku PET Center.
Plastic and Reconstructive Surgery
|August 11, 2012
Summary
Microvascular lymph node transfer for lymphedema shows minimal donor-site lymphatic flow changes. Postoperative evaluations found no significant lymphedema development in patients undergoing this procedure.
Area of Science:
- Plastic Surgery
- Microsurgery
- Lymphedema Management
Background:
- Lymphedema presents significant treatment challenges with limited curative options.
- Microvascular lymph node transfer to the axilla shows promise for improving lymphatic drainage in lymphedema patients.
- The impact of lymph node transfer on donor-site lymphatic function remains understudied.
Purpose of the Study:
- To evaluate the postoperative lymphatic function of donor sites following microvascular lymph node transfer for lymphedema.
Main Methods:
- Lymphatic groin flap transfer to the axilla was performed in 13 lymphedema patients.
- Lymph node transfer was combined with lower abdominal breast reconstruction in 10 patients.
- Postoperative lymphatic vessel function was assessed using lymphoscintigraphy and limb circumference measurements, with a numerical transport index for drainage evaluation.
Main Results:
- Six of 10 patients exhibited minor changes in donor-site limb lymphatic flow on lymphoscintigraphy.
- Two of 10 patients had a slightly abnormal transport index.
- No patient developed changes in lower limb circumference during 8- to 56-month follow-up.
Conclusions:
- Lymph node transfer is a feasible adjunct to lower abdominal breast reconstruction.
- While no patients developed lymphedema symptoms, lymphoscintigraphy highlights the importance of minimizing surgical trauma to the lymphatic flap donor site.
