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Treatment of Moderate to Severe Lymphede
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
Case 1
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
This is a 61-year-old female who had suffered from breast cancer-related lymphedema of the right upper extremity for 10 years after mastectomy, axillary 19 lymph nodes dissection, and radiotherapy. With the combined use of compression garments and the treatment of complete decongestive therapy, she had developed 2 episodes of cellulitis per year.
At 2- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 27% and 10% above and below the elbow, respectively.
At 2- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 27% and 10% above and below the elbow, respectively.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
At 12- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 36% and 15% above and below the elbow, respectively.
The skin paddle in the wrist was de-epithelialized and the left upper medial arm was subjected to liposuction at 14 and 27 months. At 36- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 60% and 10% above and below the elbow, respectively.
The skin paddle in the wrist was de-epithelialized and the left upper medial arm was subjected to liposuction at 14 and 27 months. At 36- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 60% and 10% above and below the elbow, respectively.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
At 72- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 50% above and below the elbow, respectively.
At 75- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 40% above and below the elbow, respectively.
At 75- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 40% above and below the elbow, respectively.
Case 2
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
At 3- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 38% and 25% above and below the elbow, respectively.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
At 6- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 32% and 15% above and below the elbow, respectively.
At 12- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 30% and 15% above and below the elbow, respectively.
At 12- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 30% and 15% above and below the elbow, respectively.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
The skin paddle in the wrist was de-epithelialized and the left upper medial arm was subjected to liposuction at 14 months. At 18- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 90% and 40% above and below the elbow, respectively.
At 22- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 35% above and below the elbow, respectively.
At 22- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 35% above and below the elbow, respectively.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
At 36- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 85% above and below the elbow, respectively.
Case 3
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
A 56-year-old patient with grade IV breast cancer-related lymphedema of the left upper extremity for 36 months after modified radical mastectomy, axillary lymph node dissection, and radiation. She developed 5 episodes of cellulitis per year and was refractory to conservative decongestive therapy.
At 12- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 40% and 15% above and below the elbow, respectively.
At 12- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 40% and 15% above and below the elbow, respectively.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
The skin paddle in the wrist was de-epithelialized and the left upper medial arm was subjected to liposuction at 14 months. At 21- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 70% and 30% above and below the elbow, respectively.
At 29- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 65% above and below the elbow, respectively.
At 29- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 65% above and below the elbow, respectively.
Case 4
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
A 70-year-old patient with grade III breast cancer-related lymphedema of the left upper extremity for 36 months after modified radical mastectomy, axillary lymph node dissection, and radiation. She developed 1 episodes of cellulitis per year and was refractory to conservative decongestive therapy.
At the 6-months follow-up, vascularized submental lymph node flap transfer to the wrist had significantly improved the patient’s symptoms and extremity tightness. The circumferential reduction rate was 20% above the elbow and 15% below the elbow without the use of a compression garment.
At the 6-months follow-up, vascularized submental lymph node flap transfer to the wrist had significantly improved the patient’s symptoms and extremity tightness. The circumferential reduction rate was 20% above the elbow and 15% below the elbow without the use of a compression garment.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs
At the 24-months follow-up, the reduction rate was 60% above the elbow and 50% below the elbow without the use of a compression garment.
Vascularized Lymph Node Flap Transfer (VLNT) - Upper Limbs