Complications after vascularized jejunal mesenteric lymph node transfer: A 3-year experience

Area of Science:

• Microsurgery
• Lymphedema Management
• Abdominal Surgery

Background:

• Vascularized lymph node transfer (VLNT) is a surgical treatment for refractory extremity lymphedema.
• Traditional donor sites (axilla, groin, supraclavicular) carry risks of secondary lymphedema.
• The jejunal mesentery presents an alternative donor site for lymph nodes.

Purpose of the Study:

• To evaluate the efficacy and complication rates of jejunal mesenteric VLNT for lymphedema.
• To assess the long-term outcomes of this surgical approach.

Main Methods:

• Retrospective review of patients undergoing jejunal VLNT from February 2015 to February 2018.
• Analysis of demographic data, follow-up duration, and surgical complications.
• Inclusion of concurrent omental lymph node transfers in some cases.

Main Results:

• Thirty jejunal VLNT procedures were performed on 29 patients over three years.
• The study reported a 3.3% flap loss rate.
• Post-operative complications included hernias (13.8%), small bowel obstructions (10.3%), and wound infection (3.4%).

Conclusions:

• Jejunal VLNT is a viable surgical option for lymphedema treatment, mitigating donor site lymphedema risk.
• Potential complications such as hernia and small bowel obstruction must be considered.
• This technique offers a lymph node source without inducing lymphedema at the harvest site.