Treatment of physiotherapy-refractory secondary upper limb lymphedema with vascularized lymph node transfer: A case report with clinical and bioimpedance analysis correlation
Affiliations: Division of Plastic and Reconstructive Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Correspondence:
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Corresponding author: Hin-Lun Liu, Division of Plastic and Reconstructive, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China. Tel.: +852 22554394; Fax: +852 28193780; E-mail:lawrencehlliu@gmail.com
Abstract: With radical treatment of cancer, lymphedema of limb has become a commonly
faced adverse effect. The introduction of vascularized lymph node transfer
(VLNT) has provided a possible treatment option for this troublesome
condition. In this case report, we describe a 66-year-old lady who developed
upper limb lymphedema after operation and radiotherapy for the cancer of her
left breast. Her lymphedema did not improve despite wearing pressure garment
and receiving six months of regular decongestive physiotherapy. VLNT was
performed for this patient, the pre- and post-operative limb circumference
and bioimpedance measurements were compared. After operation, the patient
continued with her previous physiotherapy regimen. Complete resolution of
pitting edema was demonstrated five months after VLNT. In addition, there
was a marked improvement in both limb circumference and bioimpedance
measurements. From this case report, VLNT appears to be a promising
treatment option for secondary lymphedema. We suggest this case report can
serve as a model for future studies.
