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American Association of Plastic Surgeons

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PHYSIOLOGIC SURGICAL OUTCOMES FOR SECONDARY UPPER EXTREMITY LYMPHEDEMA
Maureen Beederman, MD1, Rebecca M. Garza, MD1, Shailesh Agarwal, MD1, Adrian S.H. Ooi, MMed, FAMS2, David W. Chang, MD1.
1The University of Chicago, Chicago, IL, USA, 2Singapore General Hospital, Singapore, Singapore.

PURPOSE: The aim of the present study is to examine the physical and functional impact of VLNT & LVB on patients with secondary lymphedema of the upper extremity (UEL). To our knowledge, this is the largest study with long-term outcomes data of this kind to-date.
METHODS: 328 patients who underwent physiologic surgical treatment for lymphedema over a 5.5-year time period were evaluated from prospective database and medical charts. Patient demographics, surgical details, subjective reported improvements, Lymphedema Life Impact Scale (LLIS) scores, and postoperative limb volume calculations were analyzed. Statistical analysis including multivariate regression were performed.
RESULTS: 197 patients with secondary UEL was treated with VLNT in 29.4%, LVA in 9.26%, simultaneous VLNT/LVA in 52.8%, and staggered VLNT/LVA in 8.1%. The majority of patients showed both objective and subjective improvements postoperatively, with an average 31.1% reduction in limb volume difference at 3 months (p<0.01), 33.9% at 6 months (p=0.049), 25.7% at 12 months (p=0.01), and 47.4% at 2 years (p=0.099). LLIS scores were an average of 6.1% lower (p<0.01) at 3 months post-operatively, and progressively improved over time to an average of 25.3% lower at 3 years post-operatively (p=0.068).
CONCLUSION: Patients with secondary UEL who undergo VLNT/LVA demonstrated improved functional status and reduced affected limb volume at all time points postoperatively. Significant improvements were seen post-operatively as measured by LLIS scores and patient reported clinical symptoms.


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