Abstract
BackgroundVarious surgical options are available to treat lymphedema, such as direct excisional debulking surgery, suction-assisted lipectomy debulking, lymphovenous anastomosis (LVA), and vascularized lymph node transplantation (VLNT). However, no studies have addressed simultaneous surgery with both LVA and VLNT for patients with advanced-stage lymphedema. Case Presentation A 72-year-old female with bilateral lower extremity lymphedema refractory to nonsurgical management was admitted to our lymphedema clinic. This patient had a history of lymphoma and treated with radiotherapy on right inguinal area 26 years ago. Interestingly, the patient developed lymphedema on both the right and left lower extremities although she had radiotherapy on her right inguinal area. The patient underwent simultaneous vascularized lymph node transfer and lymphovenous anastomosis for treatment of end-stage lymphedema. Significant reduction in circumference and volume of lower extremity was achieved following simultaneous vascularized lymph node transfer and lymphonvenous anastomosis Conclusion The authors recommend simultaneous VLNT and LVA surgeries as the first treatment option for patients with end-stage lymphedema.
Recurrent Advanced Lower Extremity Lymphedema Following Initial Successful Vascularized Lymph Node Transfer: A Clinical and Histopathological Analysis
