Long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema

Alexander T. Nguyen, Hiroo Suami, Matthew M. Hanasono, Veda A. Womack, Franklin C. Wong, Edward I. Chang

Research output: Contribution to journalArticleResearchpeer-review

19 Citations (Scopus)

Abstract

Background: The free vascularized omental lymphatic flap provides an option without the risk for iatrogenic donor site lymphedema that plagues alternative lymph node transfer donor sites. The omental flap has been associated with significant morbidity in the past; however, with modern techniques and advanced in technology, a minimally invasive approach to flap harvest is feasible. We present the long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema. Methods: All consecutive patients with advanced lymphedema undergoing minimally invasive free vascularized omental lymphatic flap transfer were included. Perioperative evaluation included qualitative assessments, lymphoscintigraphy, and volumetric measurements. Results: Overall, 42 patients underwent a free omental lymphatic flap and had a mean follow-up of 14 (3–32) months. Subjective improvements were noted in 83% of patients. Mean volumetric improvement was 22%. Complications occurred in 16% (n = 7) of patients; this included one episode of pancreatitis and one flap loss. Postoperative imaging revealed viable lymphatic transfers. Cellulitis history was present in 74% (n = 31) patients with post-operative cellulitis occurring in 5% (n = 2) patients. Conclusions: The minimally invasive free vascularized omental lymphatic flap provides a safe donor site, a durable and versatile flap, and an efficacious therapy against lymphedema and lymphedema-related cellulitis. J. Surg. Oncol. 2017;115:84–89.

Original languageEnglish
Pages (from-to)84-89
Number of pages6
JournalJournal of Surgical Oncology
Volume115
Issue number1
DOIs
StatePublished - 1 Jan 2017

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Lymphedema
Cellulitis
Tissue Donors
Therapeutics
Lymphoscintigraphy
Plague
Pancreatitis
Lymph Nodes
Technology
Morbidity

Keywords

  • LVA
  • LVB
  • VLNT
  • lymphatic surgery
  • lymphedema
  • lymphovenous anastomosis
  • lymphovenous bypass
  • vascularized lymph node transfer

Cite this

Nguyen, Alexander T. ; Suami, Hiroo ; Hanasono, Matthew M. ; Womack, Veda A. ; Wong, Franklin C. ; Chang, Edward I. / Long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema. In: Journal of Surgical Oncology. 2017 ; Vol. 115, No. 1. pp. 84-89.
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abstract = "Background: The free vascularized omental lymphatic flap provides an option without the risk for iatrogenic donor site lymphedema that plagues alternative lymph node transfer donor sites. The omental flap has been associated with significant morbidity in the past; however, with modern techniques and advanced in technology, a minimally invasive approach to flap harvest is feasible. We present the long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema. Methods: All consecutive patients with advanced lymphedema undergoing minimally invasive free vascularized omental lymphatic flap transfer were included. Perioperative evaluation included qualitative assessments, lymphoscintigraphy, and volumetric measurements. Results: Overall, 42 patients underwent a free omental lymphatic flap and had a mean follow-up of 14 (3–32) months. Subjective improvements were noted in 83{\%} of patients. Mean volumetric improvement was 22{\%}. Complications occurred in 16{\%} (n = 7) of patients; this included one episode of pancreatitis and one flap loss. Postoperative imaging revealed viable lymphatic transfers. Cellulitis history was present in 74{\%} (n = 31) patients with post-operative cellulitis occurring in 5{\%} (n = 2) patients. Conclusions: The minimally invasive free vascularized omental lymphatic flap provides a safe donor site, a durable and versatile flap, and an efficacious therapy against lymphedema and lymphedema-related cellulitis. J. Surg. Oncol. 2017;115:84–89.",
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Long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema. / Nguyen, Alexander T.; Suami, Hiroo; Hanasono, Matthew M.; Womack, Veda A.; Wong, Franklin C.; Chang, Edward I.

In: Journal of Surgical Oncology, Vol. 115, No. 1, 01.01.2017, p. 84-89.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema

AU - Nguyen, Alexander T.

AU - Suami, Hiroo

AU - Hanasono, Matthew M.

AU - Womack, Veda A.

AU - Wong, Franklin C.

AU - Chang, Edward I.

PY - 2017/1/1

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N2 - Background: The free vascularized omental lymphatic flap provides an option without the risk for iatrogenic donor site lymphedema that plagues alternative lymph node transfer donor sites. The omental flap has been associated with significant morbidity in the past; however, with modern techniques and advanced in technology, a minimally invasive approach to flap harvest is feasible. We present the long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema. Methods: All consecutive patients with advanced lymphedema undergoing minimally invasive free vascularized omental lymphatic flap transfer were included. Perioperative evaluation included qualitative assessments, lymphoscintigraphy, and volumetric measurements. Results: Overall, 42 patients underwent a free omental lymphatic flap and had a mean follow-up of 14 (3–32) months. Subjective improvements were noted in 83% of patients. Mean volumetric improvement was 22%. Complications occurred in 16% (n = 7) of patients; this included one episode of pancreatitis and one flap loss. Postoperative imaging revealed viable lymphatic transfers. Cellulitis history was present in 74% (n = 31) patients with post-operative cellulitis occurring in 5% (n = 2) patients. Conclusions: The minimally invasive free vascularized omental lymphatic flap provides a safe donor site, a durable and versatile flap, and an efficacious therapy against lymphedema and lymphedema-related cellulitis. J. Surg. Oncol. 2017;115:84–89.

AB - Background: The free vascularized omental lymphatic flap provides an option without the risk for iatrogenic donor site lymphedema that plagues alternative lymph node transfer donor sites. The omental flap has been associated with significant morbidity in the past; however, with modern techniques and advanced in technology, a minimally invasive approach to flap harvest is feasible. We present the long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema. Methods: All consecutive patients with advanced lymphedema undergoing minimally invasive free vascularized omental lymphatic flap transfer were included. Perioperative evaluation included qualitative assessments, lymphoscintigraphy, and volumetric measurements. Results: Overall, 42 patients underwent a free omental lymphatic flap and had a mean follow-up of 14 (3–32) months. Subjective improvements were noted in 83% of patients. Mean volumetric improvement was 22%. Complications occurred in 16% (n = 7) of patients; this included one episode of pancreatitis and one flap loss. Postoperative imaging revealed viable lymphatic transfers. Cellulitis history was present in 74% (n = 31) patients with post-operative cellulitis occurring in 5% (n = 2) patients. Conclusions: The minimally invasive free vascularized omental lymphatic flap provides a safe donor site, a durable and versatile flap, and an efficacious therapy against lymphedema and lymphedema-related cellulitis. J. Surg. Oncol. 2017;115:84–89.

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KW - VLNT

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KW - lymphedema

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KW - lymphovenous bypass

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SN - 0022-4790

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