Manrique Oscar J, Bustos Samyd Said, Kapoor Trishul, Lin Jason, Ciudad Pedro, Forte Antonio J, Del Corral Gabriel, Mani Maria, Maruccia Michele, Terzic Andre
Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA.
Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA.
Gland Surg. 2020 Apr;9(2):528-538. doi: 10.21037/gs.2020.02.10.
Middle and distal insets of gastroepiploic vascularized lymph node transfer (GE-VLNT) for extremity lymphedema have been described. However, there has been no prior comparison of surgical or patient-reported outcomes between these techniques. We analyzed the outcomes between both insets in patients with extremity lymphedema.
Retrospective review of patients with extremity-lymphedema who underwent GE-VLNT. Two groups were analyzed: middle and distal recipient inset. We analyzed 6-month surgical and patient-reported outcomes using the Lymphedema Life Impact Scale-v2 (LLISv2) and scar satisfaction utilizing the Patient Scar Assessment Questionnaire (PSAQ).
Between 2017 and 2019, 26 patients with stage II unilateral extremity lymphedema underwent laparoscopically-harvested GE-VLNT (13 distal and 13 middle inset). There were no differences in patient demographics between groups. Mean hospital stay for patients with upper extremity lymphedema was 1.3 4.0 days (P<0.05), and for lower extremity lymphedema was 1.0 4.5 days (P<0.05), middle distal inset, respectively. Mean return to daily activities for patients with upper extremity lymphedema was 13.4 33.4 days (P<0.05), and for lower extremity lymphedema was 16.0 29.5 days (P<0.05), middle distal inset, respectively. Both middle and distal inset showed significant mean excess volume reduction at 6 months postoperatively for both upper and lower extremity lymphedema (upper extremity: middle inset 23.3%, distal inset: 22.0%; lower extremity: middle inset 23.3% and distal inset 13.3%). LLISv2 scores showed improved functional outcomes postoperatively in both upper and lower extremity lymphedema with both insets. Scar satisfaction with appearance and symptoms was higher with middle inset (P<0.05).
GE-VLNT is an effective surgical treatment for extremity lymphedema. The middle placement showed shorter hospital stay, early return to work and higher patient satisfaction.
已描述了用于治疗肢体淋巴水肿的胃网膜血管化淋巴结转移术（GE-VLNT）的中、远端植入部位。然而，此前尚未对这些技术之间的手术或患者报告的结果进行比较。我们分析了肢体淋巴水肿患者两种植入部位的治疗结果。
对接受GE-VLNT的肢体淋巴水肿患者进行回顾性研究。分析两组：中、远端受体植入部位。我们使用淋巴水肿生活影响量表v2（LLISv2）分析6个月时的手术和患者报告结果，并使用患者瘢痕评估问卷（PSAQ）分析瘢痕满意度。
2017年至2019年期间，26例II期单侧肢体淋巴水肿患者接受了腹腔镜采集的GE-VLNT（13例远端植入和13例中间植入）。两组患者的人口统计学特征无差异。上肢淋巴水肿患者的平均住院时间为1.3±4.0天（P<0.05），下肢淋巴水肿患者为1.0±4.5天（P<0.
