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Vascularized lymph node transfer for the treatment of lymphedema:a systematic review and metaanalysis of clinical and patient-reported outcomes

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Plastic and Aesthetic Research 2023年第1期10卷 797-812页

作者： Shreya Raman Sai Anusha Sanka Jenny Ji Lauren Yaeger Gary B.Skolnick joani m.christensen Division of Plastic and Reconstructive Surgery University of Illinois at ChicagoChicagoIL 60612USA Division of Plastic and Reconstructive Surgery Washington University School of MedicineSt.LouisMO 63110USA Bernard Becker medical Library Washington University School of MedicineSt.LouisMO 63110USA

Aim:The aim of this systematic review was to summarize clinical and patient-reported outcomes(PROs)for various vascularized lymph node transfer(VLNT)donor sites and identify gaps in the literature to guide future ***:A literature search of five databases was performed for articles related to VLNT that were published prior to November *** that included clinical outcomes or PROs from at least five adult patients who received VLNTs to treat lymphedema were ***:Sixty-six studies met the study *** studies reported improved limb circumference/volume,reduction or discontinuation of conservative therapy,infection rate reduction,improved PROs,or postoperative imaging findings reflecting functional lymph *** were significantly lower infection rates(Pmproved PROs in patients who received intra-abdominal flaps,but overall few studies reported these *** were no significant differences in complication rates at the donor or recipient site based on VLNT donor sites,or between intra-abdominal ***-abdominal VLNT donor sites,although these outcomes are not uniformly ***:This meta-analysis identified that intra-abdominal donor sites have the potential to reduce postoperative infectious episodes more than extra-abdominal donor *** recent investigations address many understudied VLNT donor sites,larger comparative studies and a standardized methodology are needed to better characterize postoperative outcomes,which can offer more concrete evidence to guide surgical practice.

关键词： Lymphedema vascularized lymph node transfer lymphedema surgery

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Vascularized omental tissue transfer for the treatment of lymphedema:a review

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Plastic and Aesthetic Research 2023年第1期10卷 46-55页

作者： Rachel Skladman William R.moritz Elijah J.Tenenbaum joani m.christensen Justin m.Sacks Division of Plastic and Reconstructive Surgery Washington University School of MedicineSt.LouisMO 63108USA

Lymphedema is a debilitating disorder caused by impaired drainage of the lymphatic *** the Western world,lymphedema most often arises secondary to the treatment of *** with lymphedema experience progressive swelling,pain,numbness,and tingling,and decreased quality of *** with persistent symptoms may be subject to chronic *** advent of microsurgery has enabled clinicians to transplant donor lymph nodes and their blood supply from a healthy site to the affected area in a procedure known as vascularized lymph node transplant(VLNT).One donor region is the *** omental lymph node transfer(VOLT)has been shown to decrease limb volume,circumference,and subjective symptoms of *** immunologic properties of the omentum make it a particularly useful lymph node donor site for patients with lymphedemarelated *** omentum may be harvested laparoscopically,with robotic assistance,or through a small laparotomy *** this review,we describe the relevant anatomy and history of VOLT as well as operative *** risks,benefits,and relevant outcome studies will be *** applications of robotic surgery to VOLT will be addressed.

关键词： Lymphedema VOLT VLNT laparoscopy laparotomy gastroepiploic vessels cellulitis

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