Abstract: The Submental Versus Groin Vascularized Lymph Node Transfer Flaps: A Head-to-Head Comparison of Surgical Outcomes for Breast Cancer Related Lymphedema (Plastic Surgery The Meeting (September 28

Sunday, September 30, 2018: 8:40 AM

Ming-Huei Cheng, MD, MBA, FACS , Plastic and Reconstructive Surgery, Chang-Gung Memorial Hospital, Taoyuan, Taiwan

Olivia A Ho, MD , Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

Marco Pappalardo, MD , Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan, Taoyuan, Taiwan

Chia-Yu Lin, MSc , Plastic and Reconstructive Surgery and Nursing, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

BACKGROUND: The groin and submental lymph node (VGLN and VSLN) flaps are valuable options in the treatment of breast cancer related lymphedema. This study was to comparing surgical complications and outcomes using VSLN and VGLN flaps transfers for breast cancer related lymphedema.

METHODS: Between January 2008 and December 2016, 43 patients undergone 13 VGLN flaps and 30 VSLN flaps transfers were retrospectively compared including flap characteristics, flap elevation time, surgical complications, donor site lymphedema, episodes of cellulitis and limb circumferential reduction rate.

RESULTS: Similar vein (2.6±0.6 vs. 3.2±1.5 mm; p=0.3) and artery diameter (2.1±0.5 vs. 2.8±0.5 mm; p=0.3) and number of lymph nodes (3±1.3 vs. 4.2±2.1; p=0.4) were found between VGLN and VSLN cohorts respectively. Flap harvest time was significantly less in the VSLN flap (108.4±13.5 vs. 144.4±12.8 min, p=0.04). Complication rates in VGLN were statistically higher for intra-operative (30.8% vs. 3.3%, p=0.04) and lower for post-operative (7.7% vs. 20%, p=0.04) incidence independently, but not total complications (38.5% vs. 23.3%, p=0.06) regardless of the reason for salvage. At a mean 39.8±22.4 months, the circumferential reduction rate was statistically higher in VSLN than VGLN group (55.5±14.3% vs. 48.4±23.9%, p=0.04). Both flaps were effectively decreased in the episodes of cellulitis.

CONCLUSION: Both VGLN and VSLN flaps are effective surgical options in treating breast cancer related lymphedema. However, the VSLN flap for breast cancer related lymphedema is better in providing more significant improvements in limb circumference, a faster flap harvest time, decreased complication rates, and minimal donor site iatrogenic lymphedema.

35648 The Submental Versus Groin Vascularized Lymph Node Transfer Flaps: A Head-to-Head Comparison of Surgical Outcomes for Breast Cancer Related Lymphedema