Gastroepiploic vascularized lymph node transfer for extremities' lymphedema: Is two better than one? A retrospective...

Area of Science:

• Vascularized lymph node transfer
• Lymphedema surgery
• Microsurgery

Background:

• Lymphedema significantly impacts quality of life.
• Gastroepiploic vascularized lymph node transfer (VLNT) is a promising treatment for extremities' lymphedema.
• Limited comparative data exists for single versus double VLNT.

Purpose of the Study:

• To compare the efficacy of single (SG-VLN) versus double gastroepiploic vascularized lymph node transfer (DG-VLN) for treating stage II and III lymphedema.
• To evaluate limb circumference reduction, cellulitis episodes, and quality of life post-surgery.

Main Methods:

• Retrospective analysis of 89 patients with lymphedema undergoing SG-VLN or DG-VLN between 2012-2018.
• Primary endpoint: limb circumference reduction at 12 months.
• Secondary endpoints: cellulitis episodes and quality of life (LYMQoL questionnaire).

Main Results:

• DG-VLN showed significantly higher limb circumference reduction at 12 months compared to SG-VLN (p<0.05).
• No significant difference in cellulitis reduction between groups.
• DG-VLN group reported better overall satisfaction, symptom management, and mood (p=0.04).

Conclusions:

• Both SG-VLN and DG-VLN yield excellent results for lymphedema treatment.
• DG-VLN may offer superior volume reduction and improved patient-reported outcomes.
• Larger studies are needed to confirm these findings.