Vascularized gastroepiploic lymph node transfer significantly improves breast cancer-related lymphedema

Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Multiple methods have been described and each has significant disadvantages.

We performed VLNT in patients with upper extremity lymphedema resulting from breast cancer surgery. We used lymph nodes of the greater curvature of the stomach (VLNTg). We describe outcomes of the patients suffering from postmastectomy lymphedema who received VLNTg for treatment of lymphedema. Harvest from the periphery of the left gastroepiploic vessel was conducted.

We retrospectively reviewed data of 24 female patients suffering from lymphedema following breast cancer treatment who underwent lymph node transplantation from 2012 to 2017. Axillary lymphadenectomy had been performed in all cases. In 18 patients, upper limb lymphedema was present for at least 1 year (mean = 5.6 years; range, 1-15 years). In 6 patients, it was present for only a few months (mean = 5 months; range, 3-8 months).

The greater curvature of the stomach nodes (VLNTg) is an excellent option for the treatment of upper extremity lymphedema because there is no risk of complications and the scar is easily concealed. Improvement from lymphedema can be expected in a majority of patients.