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Advanced Surgical Options for the Treatment of Lymphedema

  • Vascularized lymph node transfer is an innovative new surgical procedure used to treat lymphedema, a common condition for patients who have had their lymph nodes removed during the course of cancer treatment.

    Symptoms of lymphedema include fluid retention, tissue swelling and soreness of the extremities (arms, hands or legs). Research suggests that the frequency of upper extremity (arm) lymphedema in breast cancer patients can range from 8 percent to 56 percent Click [i]. Lymphedema in the lower-extremities (legs) can occur in 5 – 36 percent of patients after treatment for gynecologic cancers (vulvar, ovarian, uterine) [ii]. Thus, the procedure can benefit a wide range of patients and improve their quality of life after cancer surgery.

    During the procedure, a surgeon transplants lymph nodes from one part of the body to another part of the body that is affected by lymphedema. The procedure ensures that the lymph nodes are “alive” by reestablishing blood flow to the transplanted lymph nodes. The transplanted lymph nodes can help divert the lymphatic fluid in the affected extremity to the venous circulation. Although there is a theoretical risk of developing lymphedema in the donor extremity (patient’s arms, hands or legs), with proper lymph node selection for transfer, this can be avoided. Recent evidence shows that very few cases of developing lymphedema in the donor extremity have been reported.

    Any patient with lymphedema after cancer treatment is a potential candidate for this surgery. This procedure is now available at Fox Chase Cancer Center within the Division of Plastic and Reconstructive Surgery. Patients should always carefully review and discuss their options, including potential risks and benefits, with their doctor in order to make an informed decision regarding their care. To make an appointment or request a second opinion with Dr. Sameer Patel, please call 888-369-2427.

    [i] Paskett ED, Naughton MJ, McCoy TP, et al.: The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomarkers Prev 16 (4): 775-82, 2007.

    [ii] Beesley V, Janda M, Eakin E, et al.: Lymphedema after gynecological cancer treatment: prevalence, correlates, and supportive care needs. Cancer 109 (12): 2607-14, 2007.