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Semin Plast Surg. 2018 Feb;32(1):28-35. doi: 10.1055/s-0038-1632401. Epub 2018 Apr 9.

Vascularized Lymph Node Transfer for Lymphedema.

Author information

1
Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
2
Keck School of Medicine, University of Southern California, Los Angeles, California.
3
Division of Plastic and Reconstructive Surgery, Keck Medical Center of USC, University of Southern California, Los Angeles, California.
4
Department of Plastic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Abstract

Advances in our understanding of the lymphatic system and the pathogenesis of lymphedema have resulted in the development of effective surgical treatments. Vascularized lymph node transfer (VLNT) involves the microvascular transplantation of functional lymph nodes into an extremity to restore physiological lymphatic function. It is most commonly performed by transferring combined deep inferior epigastric artery perforator and superficial inguinal lymph node flaps for postmastectomy breast reconstruction. For patients who do not require or are unable to undergo free abdominal breast reconstruction or have lymphedema affecting the lower extremity, several other VLNT options are available. These include flaps harvested from within the axillary, inguinal, or cervical lymph node basins, and lymph node flaps from within the abdominal cavity. This article reviews the lymph node flap options and techniques available for VLNT for lymphedema.

KEYWORDS:

flap; gastroepiploic; groin; lymphedema; mesenteric; submental; supraclavicular; vascularized lymph node transfer

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