Quantification and Effectiveness of Vascularized Neck Lymph Node Transfer for Lymphedema: a Systematic Review and Meta-Analysis

Seth, Ishith; Bulloch, Gabriella; Gibson, Damien; Seth, Nimish; Hunter-Smith, David J.; Rozen, Warren M.

doi:10.1007/s12262-022-03627-6

Cited by 1 publication

(1 citation statement)

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“…Furthermore, VLNT has significantly reduced the incidence of severe cellulitis postoperatively, reducing the need for prophylactic antibiotics, which may improve patient morbidity, health care cost, and lowers the risk for antibiotic-resistance bacteria ( 39 , 42 ). Additionally, a recent meta-analysis demonstrates harvesting of level I lymph nodes is associated with low donor site morbidity, with main patient concern reported of beard hair growth ( 43 ). Treating lymphedema with simultaneous VLNT is a promising emerging technique however larger longitudinal studies with longer follow up (>24 months postoperative) studies are required to validate its true utility.…”

Section: Discussionmentioning

confidence: 99%

Quantification of level I neck lymph nodes for lymph node transfer in lymphedema treatment: an anatomical study and review of literature

Rozen¹,

Niumsawatt²,

Gibson³

et al. 2023

Gland Surg

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Background Vascularized lymph node transfer (VLNT) is an effective microsurgical method for the treatment of lymphedema. Knowledge of lymph node quantity and regional anatomy of donor sites are essential for surgery optimization. The aim of the study was to quantify the level I lymph nodes of the neck (submental and submandibular lymph nodes), describe the regional anatomy and review the current literature. Methods Level I lymph nodes were identified from pathology specimens of 73 patients in Melbourne, Australia who underwent radical, modified, and selective neck dissection were quantified. Level I was further subcategorized into levels IA (submental) and IB (submandibular), with data assessed qualitatively and quantitatively. PubMed, Google Scholar, Science Direct, Cochrane CENTRAL, and trial registries ( http://clinicialtrials.gov/ ) were searched for relevant studies published from infinity to December 2021. Results A mean of 5.2±2.9 lymph nodes were identified in the level I neck region. Subcategorization into level IA and level IB showed means of 3.7±1.6 and 4.7±3.0 lymph nodes, respectively. No statistical differences were detected regarding patients’ gender (P=0.8) and age (P=0.5). Current literature shows level I neck VLNT is a suitable treatment for lymphedema. Conclusions Level I of the neck offers a consistent quantity of lymph nodes and is suitable for free lymph node transfer. Current literature states VLNT is an effective technique for lymphedema treatment. This study details the regional anatomy of the level I neck lymph nodes, which will assist surgeons to optimize their surgeries and prevent donor-site morbidity.

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Section: Discussionmentioning

confidence: 99%