Volume 115, Issue 1 pp. 60-62
Research Article

The surgical anatomy of the supraclavicular lymph node flap: A basis for the free vascularized lymph node transfer

Johannes Steinbacher MD

Johannes Steinbacher MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

Department of Systematic Anatomy, Institute of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Austria

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Ines E. Tinhofer MD

Ines E. Tinhofer MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

Department of Systematic Anatomy, Institute of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Austria

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Stefan Meng MD

Stefan Meng MD

Department of Systematic Anatomy, Institute of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Austria

Department of Radiology, Kaiser-Franz-Josef-Hospital, Vienna, Austria

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Lukas F. Reissig MD

Lukas F. Reissig MD

Department of Systematic Anatomy, Institute of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Austria

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Eva Placheta MD

Eva Placheta MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

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Julia Roka-Palkovits MD

Julia Roka-Palkovits MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

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Thomas Rath MD

Thomas Rath MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

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Ming-Huei Cheng MD

Ming-Huei Cheng MD

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

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Wolfgang J. Weninger MD

Wolfgang J. Weninger MD

Department of Systematic Anatomy, Institute of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Austria

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Chieh Han Tzou MD

Corresponding Author

Chieh Han Tzou MD

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

Correspondence to: Chieh Han Tzou, MD, Professor of Plastic Surgery, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. Fax: +4314040069880. E-mail: [email protected]

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First published: 28 June 2016
Citations: 27
Presented at 2015 Annual Meeting of the Austrian Society for Plastic and Reconstructive Surgery, September 2015, Salzburg, Austria.
Presented at 2016 Annual Meeting of the American Society for Reconstructive Microsurgery, January 2016, Tucson, Arizona, USA.
Presented at the 5th World Symposium for Lymphedema Surgery, May 2016, Taipei, Taiwan.
The authors hereby declare that they have no conflicts of interest, particularly a financial interest, in the subject matter or materials discussed.

Abstract

Background

Vascularized lymph node transfer is an effective surgical method in reducing lymphedema. This study provides the first detailed description of the surgical anatomy of the supraclavicular lymph node flap in regard to pedicle length, pedicle diameter, and the number of lymph nodes and their exact location inside the flap.

Methods

Bilateral supraclavicular dissections of nine fresh cadavers (five female) were performed. Before the dissection, the exact number of lymph nodes was determined sonographically by an experienced radiologist, and their distance from the jugular notch was measured. After anatomic dissection, the vascular pedicle's diameter and length were measured.

Results

The mean number of lymph nodes was 1.5 ± 1.85 on the right side and 3 ± 2.26 on the left. Their mean distance from the jugular notch was 8.29 ± 2.15 cm on the right and 6.10 ± 1.21 cm on the left. The pedicle's length was 4.72 ± 1.03 cm on the right and 4.86 ± 0.99 cm on the left, and its diameter 2.03 ± 0.83 on the right and 1.80 ± 0.77 on the left.

Conclusion

The pedicle length and diameter of the supraclavicular lymph node flap are suitable for a microvascular tissue transfer. J. Surg. Oncol. 2017;115:60–62. © 2016 Wiley Periodicals, Inc.

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