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Simultaneous Vascularized Lymph Node Transfer and Breast Reconstruction: A Systematic Review
Hamzah Almadani1, Jocelyn Lu1, Sara Bokhari2
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90211, USA.
Journal of Clinical Medicine
|March 17, 2025
Summary
Simultaneous vascularized lymph node transfer (VLNT) and breast reconstruction safely treats and prevents lymphedema after cancer. This review analyzed 772 patients, finding VLNT effective with autologous reconstruction, though future research needs standardized data collection for lymphatic outcomes.
Area of Science:
- Surgical Oncology
- Plastic and Reconstructive Surgery
- Lymphedema Management
Background:
- Breast cancer treatment often leads to lymphedema, impacting quality of life.
- Simultaneous vascularized lymph node transfer (VLNT) and breast reconstruction offers a combined surgical solution.
- Current literature quality and outcomes for this combined approach require systematic analysis.
Purpose of the Study:
- To systematically review and analyze data quality and outcomes of simultaneous VLNT and breast reconstruction.
- To assess the efficacy and safety of this combined procedure in managing breast cancer-related lymphedema.
- To identify trends in reconstructive techniques and VLNT donor sites.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searches conducted on Google Scholar and PubMed using specific keywords for breast reconstruction and VLNT.
- Inclusion of original articles detailing simultaneous VLNT and breast reconstruction procedures, with data extraction on patient characteristics, treatments, and outcomes.
Main Results:
- 118 studies were included, with 42 non-review articles analyzing 772 patients.
- The mean patient age was 51.6 years, with a mean follow-up of 23.8 months.
- Autologous reconstruction (predominantly DIEP flap) was common; superficial inferior epigastric nodes were the most frequent VLNT donor site. 21.8% complications reported, mainly donor site seromas.
Conclusions:
- VLNT can be safely combined with autologous breast reconstruction for lymphedema treatment or prevention.
- The combined approach demonstrates potential benefits for patients experiencing or at risk of lymphedema.
- Standardized data collection and reporting of lymphedema and lymphatic reconstruction outcomes are crucial for future research.
