title: Treatment of physiotherapy-refractory secondary upper limb lymphedema with vascularized lymph node transfer: A case report with clinical and bioimpedance analysis correlation.
abstract: With radical treatment of cancer, lymphedema of limb has become a commonly faced adverse effect. The introduction of vascularized lymph node transfer (VLNT) has provided a possible treatment option for this troublesome condition. In this case report, we describe a 66-year-old lady who developed upper limb lymphedema after operation and radiotherapy for the cancer of her left breast. Her lymphedema did not improve despite wearing pressure garment and receiving six months of regular decongestive physiotherapy. VLNT was performed for this patient, the pre- and post-operative limb circumference and bioimpedance measurements were compared. After operation, the patient continued with her previous physiotherapy regimen. Complete resolution of pitting edema was demonstrated five months after VLNT. In addition, there was a marked improvement in both limb circumference and bioimpedance measurements. From this case report, VLNT appears to be a promising treatment option for secondary lymphedema. We suggest this case report can serve as a model for future studies.
authors.forename: Melody Man-Kuen
authors.initials: MM
authors.lastname: Wong
authors.forename: Hin-Lun
authors.initials: HL
authors.lastname: Liu
mesh_terms: D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000628:therapy*; D058128:Compression Bandages; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008198:Lymph Nodes / Q000637:transplantation*; D008209:Lymphedema / Q000628:therapy*; D008408:Mastectomy; D026741:Physical Therapy Modalities; D010992:Plethysmography, Impedance; D019233:Retreatment; D017211:Treatment Failure; D034941:Upper Extremity / Q000473:pathology
keywords: Secondary lymphedema; bioimpedance analysis; groin lymph node flap; limb circumference; lymph node transfer