Double vascularized omentum lymphatic transplant (VOLT) for the treatment of lymphedema Journal Article

Authors: Kenworthy, E. O.; Nelson, J. A.; Verma, R.; Mbabuike, J.; Mehrara, B. J.; Dayan, J. H.
Article Title: Double vascularized omentum lymphatic transplant (VOLT) for the treatment of lymphedema
Abstract: Background and Objectives: Orthotopic vascularized lymph node transplant has been successfully used to treat lymphedema. A second, heterotopic lymph node transplant in the distal extremity may provide further improvement. The vascularized omentum lymphatic transplant (VOLT) provides adequate tissue for two simultaneous flap transfers to one limb. The purpose of this study was to review our experience with this technique. Methods: We conducted a retrospective study of patients who underwent VOLT, with a subgroup analysis of patients who underwent double VOLT. Technical aspects of the procedure, complications, and early outcomes were reviewed. Results: From May 2015 to August 2017, 54 VOLTs were performed in 38 patients, of whom 16 received double VOLT. Among patients in the double VOLT group with postoperative imaging at 1 year, uptake into the transplanted omentum was seen in three of six (50%) patients on lymphoscintigraphy and in one of five (20%) patients on indocyanine green lymphangiography. One patient (3.1%) in the double VOLT group required a return to the operating room. There were no donor site complications in the double VOLT group. The overall complication rate was 15.8%. Conclusions: Double VOLT to the mid-level and proximal extremity is a safe and viable option. © 2018 Wiley Periodicals, Inc.
Keywords: adult; treatment outcome; aged; surgical technique; retrospective studies; major clinical study; follow up; follow-up studies; lymph nodes; lymphoscintigraphy; transplantation; vascularization; retrospective study; lymphedema; graft failure; sensory nerve; lymph node; pancreatitis; hernia; minimally invasive surgery; disease duration; risk reduction; free tissue graft; hematoma; ileus; angiography; small intestine obstruction; enoxaparin; venous thromboembolism; cellulitis; lymphangiography; vein blood flow; forearm; omentum; soft tissue infection; subcutaneous fat; free tissue flaps; manual lymphatic drainage; indocyanine green; minimally invasive surgical procedures; upper limb; artery anastomosis; humans; human; male; female; priority journal; article; vein anastomosis; lower limb; double omentum; vascularized lymph node transfer; volt; cephalic vein; flexor carpi radialis muscle; flexor muscle; vascularized omentum lymphatic transplant
Journal Title: Journal of Surgical Oncology
Volume: 117
Issue: 7
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2018-06-01
Start Page: 1413
End Page: 1419
Language: English
DOI: 10.1002/jso.25033
PUBMED: 29518822
PROVIDER: scopus
PMCID: PMC6754210
Notes: Article -- Export Date: 1 August 2018 -- Source: Scopus
Citation Impact
MSK Authors
  1. Babak Mehrara
    307 Mehrara
  2. Joseph Henry Dayan
    40 Dayan
  3. Jonas Allan Nelson
    39 Nelson
  4. Richa Verma
    3 Verma