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Flores T, Bergmeister KD, Staudenherz A, Pieber K, Schrögendorfer KF. [Diagnosis, prevention and therapy of lymphedema]. Wien Klin Wochenschr 2020; 133:855-868. [PMID: 33226525 PMCID: PMC8452052 DOI: 10.1007/s00508-020-01766-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Tonatiuh Flores
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich. .,Klinische Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Österreich.
| | - Konstantin D Bergmeister
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.,Klinische Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Österreich
| | - Anton Staudenherz
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.,Klinisches Institut für Nuklearmedizin, molekulare Bildgebung und spezielle Endokrinologie, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Österreich
| | - Karin Pieber
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.,Klinisches Institut für Physikalische Medizin und Rehabilitation, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Österreich
| | - Klaus F Schrögendorfer
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.,Klinische Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Österreich
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Abdelfattah U, Elbanoby T, Ayad W, Elshamy M, Allam E. Treatment of secondary scrotal and lower extremity lymphedema using combined pedicled lymph node transfer and lymphaticovenous anastomosis: A case report. Microsurgery 2020; 40:901-905. [PMID: 32956532 DOI: 10.1002/micr.30656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/07/2020] [Accepted: 09/10/2020] [Indexed: 11/07/2022]
Abstract
Combined secondary scrotal and lower extremity lymphedema is an infrequent complication of radical excision of urogenital cancers associated with pelvic lymphadenectomy. Scrotal lymphedema is usually psychologically distressing, and difficult to treat. We report a case of a 41-years old male who presented with scrotal and left lower extremity lymphedema after radical prostatectomy and pelvic lymphadenectomy successfully treated with pedicled superficial inguinal lymph node (SILN) transfer and lymphaticovenous anastomosis (LVA) restoring the lymphatic drainage. The flap consisted of subscarpal adipofascial tissue between the level of the inguinal ligament and the groin crease measuring 11 × 7 cm. The flap composed of afferent lymphatics from the lower abdomen, lymph nodes, and fatty tissue without skin, the right-sided flap was transposed to the root of scrotum while the left one to the proximal left thigh, then two-level LVA were performed in the left extremity. The surgery went uneventful with no postoperative complications. At a 9 month follow-up, there was a significant reduction of the scrotal volume with a reduction of excess volume of the lower extremity from 49.6 to 9.4% compared with the healthy side. No cellulitis was reported during the follow-up period with improvement in the patient's clinical symptoms and quality of life. We believe that pedicled superficial inguinal lymph node flap together with LVA is a reliable and safe treatment option for either scrotal or lower extremity lymphedema following pelvic cancer treatment.
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Affiliation(s)
- Usama Abdelfattah
- Plastic and Reconstructive Surgery Department, Al-Azhar University, Cairo, Egypt
| | - Tarek Elbanoby
- Plastic and Reconstructive Surgery Department, Al-Azhar University, Cairo, Egypt
| | - Wael Ayad
- Plastic and Reconstructive Surgery Department, Al-Azhar University, Cairo, Egypt
| | | | - Eatmad Allam
- Physiotherapy Department, Al-Azhar University, Cairo, Egypt
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