Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation
- PMID: 16495693
- PMCID: PMC1448940
- DOI: 10.1097/01.sla.0000201258.10304.16
Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation
Abstract
Background and objectives: Lymphedema complicating breast cancer treatment remains a challenging problem. The purpose of this study was to analyze the long-term results following microsurgical lymph node (LN) transplantation.
Methods: Twenty-four female patients with lymphedema for more than 5 years underwent LN transplantation. They were treated by physiotherapy and resistant to it. LNs were harvested in the femoral region, transferred to the axillary region, and transplanted by microsurgical procedures. Long-term results were evaluated according to skin elasticity, decrease, or disappearance of lymphedema assessed by measurements, isotopic lymphangiography, and ability to stop physiotherapy.
Results: The postoperative period was uneventful; skin infectious diseases disappeared in all patients. Upper limb perimeter returned to normal in 10 cases, decreased in 12 cases, and remained unchanged in 2 cases. Five of 16 (31%) isotopic lymphoscintigraphies demonstrated activity of the transplanted nodes. Physiotherapy was discontinued in 15 patients (62.5%). Ten patients were considered as cured, important improvement was noted in 12 patients, and only 2 patients were not improved.
Conclusion: LN transplantation is a safe procedure permitting good long-term results, disappearance, or a noteworthy improvement, in postmastectomy lymphedema, especially in the early stages of the disease.
Similar articles
-
Postmastectomy neuropathic pain: results of microsurgical lymph nodes transplantation.Breast. 2008 Oct;17(5):472-6. doi: 10.1016/j.breast.2007.12.007. Epub 2008 May 1. Breast. 2008. PMID: 18450444
-
Lymphaticovenular bypass surgery for lymphedema management in breast cancer patients.Handchir Mikrochir Plast Chir. 2012 Dec;44(6):343-7. doi: 10.1055/s-0032-1323762. Epub 2012 Sep 24. Handchir Mikrochir Plast Chir. 2012. PMID: 23007714
-
Microvascular breast reconstruction and lymph node transfer for postmastectomy lymphedema patients.Ann Surg. 2012 Mar;255(3):468-73. doi: 10.1097/SLA.0b013e3182426757. Ann Surg. 2012. PMID: 22233832
-
Free vascularized lymph node transfer for treatment of lymphedema: A systematic evidence based review.J Plast Reconstr Aesthet Surg. 2016 Sep;69(9):1234-47. doi: 10.1016/j.bjps.2016.06.022. Epub 2016 Jul 1. J Plast Reconstr Aesthet Surg. 2016. PMID: 27425000 Review.
-
Comprehensive review of vascularized lymph node transfers for lymphedema: Outcomes and complications.Microsurgery. 2018 Feb;38(2):222-229. doi: 10.1002/micr.30079. Epub 2016 Jun 7. Microsurgery. 2018. PMID: 27270748 Review.
Cited by
-
Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling.Ann Surg Oncol. 2015 Dec;22 Suppl 3:S1263-70. doi: 10.1245/s10434-015-4700-3. Epub 2015 Jun 30. Ann Surg Oncol. 2015. PMID: 26122375 Free PMC article.
-
Demystifying vascularized lymph node transfers and lymphatico-venous anastomoses.Ann Transl Med. 2024 Feb 1;12(1):8. doi: 10.21037/atm-23-132. Epub 2023 Jul 10. Ann Transl Med. 2024. PMID: 38304897 Free PMC article. Review.
-
Experimental assessment of pro-lymphangiogenic growth factors in the treatment of post-surgical lymphedema following lymphadenectomy.Breast Cancer Res. 2010;12(5):R70. doi: 10.1186/bcr2638. Epub 2010 Sep 8. Breast Cancer Res. 2010. PMID: 20825671 Free PMC article.
-
The lymphatic vasculature in disease.Nat Med. 2011 Nov 7;17(11):1371-80. doi: 10.1038/nm.2545. Nat Med. 2011. PMID: 22064427 Review.
-
Lymphatic Territories (Lymphosomes) in the Rat: An Anatomical Study for Future Lymphatic Research.Plast Reconstr Surg. 2017 Nov;140(5):945-951. doi: 10.1097/PRS.0000000000003776. Plast Reconstr Surg. 2017. PMID: 29068930 Free PMC article.
References
-
- Földi M. Treatment of lymphoedema. Lymphology. 1994;27:1–5. - PubMed
-
- Becker C, Hidden G, Godart S, et al. Free lymphatic transplant. Eur J Lymphol Rel Prob. 1991;6:25–77.
-
- Bernars MJ, Witte CL, Witte MH, et al. The diagnosis and treatment of peripheral lymphedema: draft revision of the 1995 consensus document of the International Society of Lymphology Executive Committee for Discussion at the September 3–7, 2001 XVIII International Congress of Lymphology in Genoa, Italy. Lymphology. 2001;34:84–91. - PubMed
-
- Campisi C. Surgery for the treatment of lymphedema. Eur J Lymph Rel Prob. 2002;10:24–27.
-
- Shesol BF, Nakashima R, Alavi A, et al. Successful lymph node transplantation in rats, with restoration of lymphatic function. Plast Recontr Surg. 1979;63:817–823. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical