CLINICAL ARTICLE

Prophylactic lymphaticovenous anastomoses for resection of soft tissue tumors of the thigh to prevent secondary lymphedema–a retrospective comparative cohort analysis

Corresponding Author

Johannes Maximilian Wagner MD

[email protected]

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

Correspondence

Björn Behr and Johannes Maximilian Wagner, Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp Platz 1, 44789 Bochum, NRW, Germany.

Email: [email protected] and [email protected]

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Mehran Dadras MD,

Mehran Dadras MD

orcid.org/0000-0003-1283-2982

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Dominic Ufton,

Dominic Ufton

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Julika Huber MD,

Julika Huber MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Christoph Wallner MD,

Christoph Wallner MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Alexander Sogorski MD,

Alexander Sogorski MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Maxi von Glinski MD,

Maxi von Glinski MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Joon Pio Hong MD, PhD,

Joon Pio Hong MD, PhD

Department of Plastic Surgery, Asan Medical Center, University of Ulsan, Seoul, South Korea

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Marcus Lehnhardt MD,

Marcus Lehnhardt MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Björn Behr MD,

Corresponding Author

Björn Behr MD

[email protected]

orcid.org/0000-0002-3480-6956

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

Correspondence

Björn Behr and Johannes Maximilian Wagner, Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp Platz 1, 44789 Bochum, NRW, Germany.

Email: [email protected] and [email protected]

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Johannes Maximilian Wagner MD,

Corresponding Author

Johannes Maximilian Wagner MD

[email protected]

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

Correspondence

Björn Behr and Johannes Maximilian Wagner, Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp Platz 1, 44789 Bochum, NRW, Germany.

Email: [email protected] and [email protected]

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Mehran Dadras MD,

Mehran Dadras MD

orcid.org/0000-0003-1283-2982

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Dominic Ufton,

Dominic Ufton

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Julika Huber MD,

Julika Huber MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Christoph Wallner MD,

Christoph Wallner MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Alexander Sogorski MD,

Alexander Sogorski MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Maxi von Glinski MD,

Maxi von Glinski MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Joon Pio Hong MD, PhD,

Joon Pio Hong MD, PhD

Department of Plastic Surgery, Asan Medical Center, University of Ulsan, Seoul, South Korea

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Marcus Lehnhardt MD,

Marcus Lehnhardt MD

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

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Björn Behr MD,

Corresponding Author

Björn Behr MD

[email protected]

orcid.org/0000-0002-3480-6956

Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

Correspondence

Björn Behr and Johannes Maximilian Wagner, Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp Platz 1, 44789 Bochum, NRW, Germany.

Email: [email protected] and [email protected]

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First published: 23 December 2021

https://doi.org/10.1002/micr.30850

Citations: 3

Johannes M. Wagner and Mehran Dadras contributed equally to this work.

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Abstract

Background

Patients with soft tissue tumors of extremities are at risk to develop secondary lymphedema after tumor resection caused by disruption of lymphatic vessels and sclerosis. Subsequently, this study aimed to evaluate the beneficial effects of lymphaticovenous anastomoses (LVAs) after soft tissue tumor resection of the thigh in a prophylactic approach.

Methods

In a retrospective cohort study, we compared eight patients with a median age of 68.5 years (49–80) who received LVAs in combination with tumor resection for treatment of soft tissue tumors of the thigh region with a prior cohort of 20 patients with a median age of 63.0 years (23–84) who received soft tissue sarcoma resection of the thigh region. All patients of LVA cohort received 1–2 LVAs (mean 1.25 ± 0.49) at the dorsum of the foot and three patients at the SEKI-point (mean 0.375 ± 0.51). Mean maximum tumor diameter of LVA group was 19.5 ± 5.2 cm and 12.3 ± 6.6 cm of control group. All patients receiving LVA were assessed for development of lymphedema via bilateral measurements of circumference and assessment of lymphedema quality of life index (LyQLI).

Results

One of the eight patients who received LVAs showed moderate impairment in the LyQLI at a follow-up of 12 months while 45% of the control cohort complained about symptoms of secondary lymphedema at a median follow-up of 22 months (p-values LyQLI: p = .018 [physical domain]; p = .018 [psychosocial domain]; p = .020 [practical domain]).

Conclusion

LVAs performed in combination with tumor resection of thigh soft tissue tumors reduce negative consequences of lymph stasis and prevent development of secondary lymphedema.

Open Research

DATA AVAILABILITY STATEMENT

The authors confirm that the data supporting the findings of this study are available within the article.

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Volume42, Issue3

March 2022

Pages 239-245

Prophylactic lymphaticovenous anastomoses for resection of soft tissue tumors of the thigh to prevent secondary lymphedema–a retrospective comparative cohort analysis

Abstract

Background

Methods

Results

Conclusion

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Information

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Prophylactic lymphaticovenous anastomoses for resection of soft tissue tumors of the thigh to prevent secondary lymphedema–a retrospective comparative cohort analysis

Abstract

Background

Methods

Results

Conclusion

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Related

Information