Outcomes in Vascularized Lymph Node Transplantation in Rabbits: A Reliable Model for Improving the Surgical Approach to Lymphedema.

Abstract

Background: Conservative nonsurgical treatment has traditionally been applied to lymphedema. Early surgical procedures were invasive and disfiguring and their long-term success was often limited. In contrast, contemporary surgical techniques are much less invasive and have been shown to be effective in reducing excess limb volume, the risk of cellulitis, and the need for compression garments. Microsurgical procedures such as lymphovenous anastomosis and vascularized lymph node transfer can treat the excess fluid component of lymphedema and are gaining in popularity. In this study, we first evaluate the possibility of generating lymphedema in the hind limb of a rabbit and then describe its treatment with microsurgical lymph node transfer without lymph vessel transfer. Methods and Results: In experimental rabbit models, animals first underwent surgery in which the popliteal lymph node was removed to create lymphedema in the hind limb. After 15 days, another operation was performed to excise the contralateral popliteal lymph node and transfer it to the limb with lymphedema. Our model showed that lymph node transfer was able to reduce lymphedema in the rabbit's hind limb; intervened hind limb: basal volume (51.94 ± 11.23), volume day transfer (73.40 ± 26.47), and final volume (50.13 ± 12). Conclusion: We have developed a feasible model to microsurgically induce and treat lymphedema by lymph node transfer that shows promising results.