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

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    68 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.

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

    Keywords

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

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