Premium
Long‐term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema
Author(s) -
Nguyen Alexander T.,
Suami Hiroo,
Hanasono Matthew M.,
Womack Veda A.,
Wong Franklin C.,
Chang Edward I.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24379
Subject(s) - medicine , lymphedema , cellulitis , surgery , lymphatic system , perioperative , free flap , microsurgery , lymph node , cancer , breast cancer , pathology
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 . © 2016 Wiley Periodicals, Inc.