Greater Omental Lymph Node Flap for Upper Limb Lymphedema with Lymph Nodes-depleted Patient

Plastic and Reconstructive Surgery. Global Open
Yu-Ying ChuMing-Huei Cheng

Abstract

The greater omentum is supplied by the right, middle, and left omental arteries, which arise from the right and left gastroepiploic arteries. All or part of the greater omentum can be harvested based on this blood supply for free tissue transfer. It has stimulated new interest in its use as the donor site in the treatment of lymphedema. For patients who have failed other management options or have limited peripheral lymph node donor sites, the greater omental lymph node flap may offer the best chance for lymphedema treatment. We report a 59-year-old woman with a history of left breast cancer who was treated with left modified radical mastectomy and axillary lymph node dissection and developed left upper extremity Grade IV lymphedema. She received vascularized groin lymph node transfer and lymphaticovenous anastomosis, but the result was not satisfactory. She also had nasopharyngeal cancer that was treated with radiotherapy to the head and neck, making use of the submental lymph nodes flap impossible. Due to a lack of other options of lymph node donor sites, the split greater omental lymph node flap (GOLF) was used. After surgery, it showed an arm circumference reduction of 42.9% above the elbow and 36.4% below the elbow at an 8...Continue Reading

References

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Citations

May 23, 2020·Plastic and Reconstructive Surgery. Global Open·Hidehiko YoshimatsuAkitatsu Hayashi
Feb 24, 2018·Journal of Surgical Oncology·Michele MarucciaGiuseppe Giudice
May 23, 2020·Plastic and Reconstructive Surgery. Global Open·Jordan D FreyJamie P Levine
Mar 9, 2021·Plastic and Reconstructive Surgery. Global Open·Chad M TevenAlanna M Rebecca
Aug 25, 2020·Mayo Clinic Proceedings·Oscar J ManriqueHung-Chi Chen
Oct 12, 2021·Journal of Surgical Oncology·Bassem W DanielAndrej Ring

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