{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T16:24:59Z","timestamp":1774715099500,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:00:00Z","timestamp":1562198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Retroperitoneal lymphangiomatosis (RL) is a rare form of primary lymphedema featuring aberrant retroperitoneal lymphatic proliferation. It causes recurrent cellulitis, repeated interventions, and poor life quality. This study aimed to investigate proper diagnositc criteria and surgical outcomes for RL with extremity lymphedema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2012 and 2018, 44 primary lower\u2010extremity lymphedema cases received lymphoscintigraphy, magnetic resonance imaging, and single\u2010photon electron computed tomography to detect RL. RL patients underwent vascularized lymph node transfers (VLNT) for extremity lymphedema and intra\u2010abdominal side\u2010to\u2010end chylovenous bypasses (CVB) for chylous ascites. Complications, CVB patency, and quality of life were evaluated postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six RL patients (mean age of 30.3 years) had chylous ascites with five had lower\u2010extremity lymphedema. All CVBs remained patent, though one required re\u2010anastomosis, giving a 100% patency rate. Four unilateral and one bilateral extremity lymphedema underwent six VLNTs with 100% flap survival. Patients reported improved quality of life (<jats:italic>P<\/jats:italic>\u2009=\u20090.023), decreased cellulitis incidence (<jats:italic>P<\/jats:italic>\u2009=\u20090.041), and improved mean lymphedema circumference (<jats:italic>P<\/jats:italic>\u2009=\u20090.043). All patients resumed a normal diet and activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Evaluating primary lower\u2010extremity lymphedema patients with MRI and SPECT could reveal a 13.6% prevalence of RL and guide treatment of refractory extremity lymphedema. Intra\u2010abdominal CVB with VLNT effectively treated RL with chylous ascites and extremity lymphedema.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25514","type":"journal-article","created":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T05:09:08Z","timestamp":1562303348000},"page":"75-84","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Intra\u2010abdominal chylovenous bypass treats retroperitoneal lymphangiomatosis"],"prefix":"10.1002","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-3461","authenticated-orcid":false,"given":"Courtney","family":"Chen","sequence":"first","affiliation":[{"name":"UC San Diego School of Medicine San Diego California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung\u2010Yu","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention Chang Gung Memorial Hospital Taoyuan 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