Abstract:
BACKGROUND:Vascularized groin lymph node flap transfer is an emerging approach to the treatment of postmastectomy upper limb lymphedema. The authors describe the pertinent flap anatomy, surgical technique including different recipient sites, and outcome of this technique. METHODS:Ten cadaveric dissections were performed to clarify the vascular supply of the superficial groin lymph nodes. Ten patients underwent vascularized groin lymph node flap transfer for postmastectomy upper limb lymphedema using the wrist (n=8) or elbow (n=2) as a recipient site. Ten patients who chose to undergo physical therapy were used as controls. Intraoperatively, indocyanine green was injected subcutaneously on the flap margin to observe the lymph drainage. Outcomes were assessed using improvement of circumferential differentiation, reduction rate, and decreased number of episodes of cellulitis. RESULTS:A mean 6.2±1.3 groin lymph nodes with consistent pedicles were identified in the cadaveric dissections. After indocyanine injection, the fluorescence was drained from the flap edge into the donor vein, followed by the recipient vein. At a mean follow-up of 39.1±15.7 months, the mean improvement of circumferential differentiation was 7.3±2.7 percent and the reduction rate was 40.4±16.1 percent in the vascularized groin lymph node group, which were statistically greater than those of the physical therapy group (1.7±4.6 percent and 8.3±34.7 percent, respectively; p<0.01 and p=0.02, respectively). CONCLUSIONS:The superficial groin lymph nodes were confirmed as vascularized with reliable arterial perfusion. Vascularized groin lymph node flap transfer using the wrist or elbow as a recipient site is an efficacious approach to treating postmastectomy upper limb lymphedema. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Cheng MH,Chen SC,Henry SL,Tan BK,Chia-Yu Lin M,Huang JJdoi
10.1097/PRS.0b013e31828bd3b3subject
Has Abstractpub_date
2013-06-01 00:00:00pages
1286-1298issue
6eissn
0032-1052issn
1529-4242pii
00006534-201306000-00009journal_volume
131pub_type
杂志文章abstract::The pathologic cause of both rare craniofacial clefts and congenital limb ring constrictions is the subject of some debate. Uncommon though these two conditions are, they have often been anecdotally reported in association. This study sought to determine the frequency of congenital limb anomalies in general and limb r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199803000-00010
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究,随机对照试验
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