{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:57:23Z","timestamp":1790009843456,"version":"4.0.1"},"reference-count":64,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T00:00:00Z","timestamp":1567728000000},"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":["Microsurgery"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vascularized lymph node transfer (VLNT) is an emerging surgical treatment for lymphedema. However, literature\u2010comparing outcomes of upper limb lymphedema (ULL) and lower limb lymphedema (LLL) is limited. Hence, the aim of this study is to compare the long\u2010term clinical outcomes on ULL versus LLL in patients treated with VLNT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study retrieving data from patients with International Society of Lymphology (ISL) stages II\u2013III who underwent different VLNTs from July 2010 to July 2016 in our institution was performed. Demographics preoperatively, and clinical data (limb circumference, infectious episodes, lymphoscintigraphic studies) preoperatively and postoperatively were recorded. Clinical outcomes by extremity were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 83 patients with lymphedema (ULL: <jats:italic>n<\/jats:italic> = 30, LLL: <jats:italic>n<\/jats:italic> = 53) were included. Mean follow\u2010up time was 32.8 months (range 24\u201349\u2009months). Mean circumference reduction was higher in patients with ULL compared to with LLL (28.6\u2009\u00b1\u20098.6 vs. 22.3\u2009\u00b1\u200910.1, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and for patients with secondary lymphedema (24.8\u2009\u00b1\u20099.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) than for patients with primary lymphedema (18.9\u2009\u00b1\u200914, <jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). Infectious episodes per year preoperative and postoperative showed that LLL patients had higher reduction on infection rate compared with ULL patients (2.4\u2009\u00b1\u20091.1 vs. 1.9\u2009\u00b1\u20091.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VLNT is a promising surgical treatment option for patients with lymphedema. This study suggests that VLNT may have a more beneficial outcome in patients with ULL and with secondary lymphedema.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30508","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T09:40:13Z","timestamp":1567762813000},"page":"130-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Comparisons in long\u2010term clinical outcomes among patients with upper or lower extremity lymphedema treated with diverse vascularized lymph node transfer"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4646-2676","authenticated-orcid":false,"given":"Pedro","family":"Ciudad","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Burn Surgery Arzobispo Loayza National Hospital  Lima Peru"},{"name":"Department of Plastic and Reconstructive Surgery China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar J.","family":"Manrique","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samyd S.","family":"Bustos","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J. P.","family":"Coca","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Burn Surgery Arzobispo Loayza National Hospital  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0463-7346","authenticated-orcid":false,"given":"Chang\u2010Cheng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-2065","authenticated-orcid":false,"given":"Pin\u2010Keng","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Nicoli","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-3614","authenticated-orcid":false,"given":"Federico","family":"Lo Torto","sequence":"additional","affiliation":[{"name":"Sapienza Universit\u00e0 di Roma, Policlinico Umberto I, Department of Surgery \u201cP. Valdoni\u201d Unit of Plastic Reconstructive and Aesthetic Surgery  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0242-0941","authenticated-orcid":false,"given":"Mouchammed","family":"Agko","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Medical College of Georgia Augusta University  Augusta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0462-7786","authenticated-orcid":false,"given":"Tony C.\u2010T.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Maruccia","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation University of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,6]]},"reference":[{"issue":"3","key":"e_1_2_7_2_1","first-page":"66","article-title":"Lymphedema of the extremities: Prospects of microsurgical treatment","volume":"9","author":"Abalmasov K. 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