Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema
Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema
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DOI：
10.1097/prs.0000000000004793
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发表时间：
2018-10-01
影响因子：
3.6
通讯作者：
Cheng, Ming-Huei
中科院分区：
文献类型：
--
作者：
Gustafsson, Jonas;Chu, Sung-Yu;Cheng, Ming-Huei
背景资料：血管化淋巴结转移在下肢水肿的治疗中显示出有希望的结果，但对于转移所需的淋巴结数量以达到最佳效果知之甚少。本研究探讨了转移淋巴结的数目之间的相关性，在颏下血管化淋巴结转移和结果，关于肢体周长减少和蜂窝织炎incidence.Methods：35例患者接受了血管化颏下淋巴结转移到踝关节下肢水肿以下妇科癌症治疗被列入研究。术前、术后用皮尺测量肢体周径，计算周径差。术后进行超声检查，以确定转移皮瓣内的淋巴结数量。根据转移淋巴结的数量将患者分为A至C组：1或2（n = 10），3或4（n = 14），5至8（n = 11），分别为。所有皮瓣均存活。整个队列的周向差异平均改善为19.8 ± 9.2%。B组和C组的周向差异改善均显著高于A组（分别为p = 0.04和p = 0.02），但相互比较时，差异无显著性。所有组有显着减少蜂窝织炎的发病率postoperatives.Conclusions：颏下血管化淋巴结转移下肢水肿减少蜂窝织炎的发病率，无论转移淋巴结的数量。转移三个或更多个淋巴结比转移两个或更少个淋巴结在肢体周长减少方面提供了显著更好的结果。
Background: Vascularized lymph node transfer has shown promising results in the treatment of lower limb lymphedema, but little is known about the number of lymph nodes needed for the transfer to achieve optimal results. This study investigated the correlation between number of transferred lymph nodes in submental vascularized lymph node transfer and outcomes regarding limb circumference reduction and cellulitis incidence.Methods: Thirty-five patients who had received vascularized submental lymph node transfer to an ankle for lower limb lymphedema following gynecologic cancer treatment were included in the study. Limb circumference was determined by means of tape measurement preoperatively and postoperatively and was used to calculate the circumferential difference. Ultrasonography was performed postoperatively to determine the number of lymph nodes within the transferred flap. Patients were divided into groups A through C depending on the number of transferred lymph nodes: 1 or 2 (n = 10), 3 or 4 (n = 14), and 5 to 8 (n = 11), respectively.Results: The mean age of the patients was 60.0 +/- 9.2 years. All flaps survived. The mean improvement of circumferential difference for the whole cohort was 19.8 +/- 9.2 percent. Groups B and C both had significantly higher improvements in the circumferential difference than group A (p = 0.04 and p = 0.02, respectively), but when compared to each other, the difference was nonsignificant. All groups had significant reductions in the incidence of cellulitis postoperatively.Conclusions: Submental vascularized lymph node transfer for lower limb lymphedema reduced the incidence of cellulitis, regardless of the number of transferred lymph nodes. The transfer of three or more lymph nodes provided significantly better outcome regarding limb circumference reduction than the transfer of two or fewer lymph nodes.