Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.
Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Cancer Rep (Hoboken). 2021 Aug;4(4):e1370. doi: 10.1002/cnr2.1370. Epub 2021 Apr 7.
Vascularized omental lymphatic transplant (VOLT) is an increasingly popular treatment of extremity lymphedema given its promising donor site. While the success of VOLT in the treatment of lymphedema has been reported previously, several questions remain.
To further elucidate appropriate use of VOLT in the treatment of lymphedema, specifically addressing patient selection, harvest technique, and operative methods.
A systematic review of VOLT for upper extremity lymphedema was performed. Of 115 yield studies, seven were included for analysis based on inclusion and exclusion criteria. Included studies demonstrated significant reductions in extremity circumference/volume (average volume reduction, 22.7%-39.5%) as well as subjective improvements using patient-reported outcomes. Though studies are heterogenous and limited, when analyzed in aggregate, suggest the efficacy of VOLT in lymphedema treatment.
This is the largest systematic review of VOLT to date. VOLT continues to show promise as a safe and efficacious surgical intervention for lymphedema in the upper extremity. Further studies are warranted to more definitively identify patients for whom this technique is appropriate as well as ideal harvest and inset technique.
带血管蒂网膜淋巴移植（VOLT）是一种越来越受欢迎的治疗肢体淋巴水肿的方法，因为它有很好的供区。尽管 VOLT 在治疗淋巴水肿方面的成功已有报道，但仍存在一些问题。
进一步阐明 VOLT 在治疗淋巴水肿中的适当应用，特别是针对患者选择、采集技术和手术方法。
对用于治疗上肢淋巴水肿的 VOLT 进行了系统评价。在 115 项产量研究中，根据纳入和排除标准，有 7 项被纳入分析。纳入的研究表明，上肢周长/体积（平均体积减少 22.7%-39.5%）以及使用患者报告的结果显示出显著的主观改善。尽管研究存在异质性和局限性，但综合分析表明，VOLT 在淋巴水肿治疗中的疗效。
这是迄今为止对 VOLT 的最大系统评价。VOLT 继续作为上肢淋巴水肿的一种安全有效的手术干预方法具有广阔的前景。需要进一步的研究来更明确地确定哪些患者适合这种技术，以及理想的采集和植入技术。
