{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T09:55:02Z","timestamp":1768643702891,"version":"3.49.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T00:00:00Z","timestamp":1741996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Lymphedema is a chronic and progressive condition that leads to significant morbidity, including recurrent infections, fibrosis, and functional limitations. Conservative treatments often offer limited relief, particularly in severe cases. Vascularized lymph node transfer (VLNT), especially using the gastroepiploic lymph node flap, has emerged as a promising intervention. This study evaluates the long-term outcomes of gastroepiploic VLNT combined with suction-assisted lipectomy (SAL) for extremity lymphedema. Materials and Methods: A retrospective review was conducted on 53 patients treated for lymphedema at our clinic in Taiwan from January 2016 to August 2023. The inclusion criteria required patients to have persistent lymphedema for at least six months despite conservative treatment. VLNT was performed using a laparoscopic approach, and postoperative assessments included limb circumference measurements, lymphoscintigraphy, and tonicity evaluations. Results: Follow-up data were collected for a minimum of 12 months. At a mean follow-up of 14.2 months, significant reductions in limb circumference were observed\u201435.5% \u00b1 24.9% for upper limbs and 32.2% \u00b1 4.5% for lower limbs. Tonicity improved by 6.2%, and no cellulitis episodes were reported post-surgery. Minor complications included hematoma and sensory changes, with no major donor-site morbidity. Lymphoscintigraphy confirmed improved lymphatic drainage. Conclusions: Gastroepiploic VLNT combined with SAL is an effective and safe treatment for severe extremity lymphedema, providing significant improvements in limb size and tissue tonicity. This technique offers a promising solution for refractory cases.<\/jats:p>","DOI":"10.3390\/medicina61030503","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T08:57:02Z","timestamp":1742201822000},"page":"503","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gastroepiploic Vascularized Lymph Node Transfer for Extremity Lymphedema: Tips and Insights from Extensive Clinical Experience"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-2191","authenticated-orcid":false,"given":"Mirco","family":"Pozzi","sequence":"first","affiliation":[{"name":"Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56121 Pisa, Italy"},{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6733-940X","authenticated-orcid":false,"given":"Davide Di","family":"Secl\u00ec","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"Surgery and Neuroscience-Plastic Surgery Unit, Department of Medicine, University of Siena, Policlinico Santa Maria \u201cLe Scotte\u201d, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-2873","authenticated-orcid":false,"given":"Alberto","family":"Bolletta","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56121 Pisa, Italy"},{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cigna","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56121 Pisa, Italy"},{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2340-162X","authenticated-orcid":false,"given":"Chiara","family":"Camilloni","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Department of Medicine and Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beniamino","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Department of Medicine and Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Persichetti","sequence":"additional","affiliation":[{"name":"Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Department of Medicine and Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3897-812X","authenticated-orcid":false,"given":"Michela","family":"Schettino","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"Unit of Plastic and Reconstructive Surgery, CHIREC de Braine L\u2019Alleud Hospital, 1410 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9105-1839","authenticated-orcid":false,"given":"Luigi","family":"Losco","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"},{"name":"Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung 404, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e70014","DOI":"10.1002\/micr.70014","article-title":"Effective 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