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Volume 42 Issue 2
Feb.  2026
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2026  >  42(2): 189-195
Chen JY,Hu WJ,Zhang WH,et al.Selection strategies and progress of donor and recipient sites for vascularized lymph node transfer[J].Chin J Burns Wounds,2026,42(2):189-195.DOI: 10.3760/cma.j.cn501225-20250220-00076.
Citation: Chen JY,Hu WJ,Zhang WH,et al.Selection strategies and progress of donor and recipient sites for vascularized lymph node transfer[J].Chin J Burns Wounds,2026,42(2):189-195.DOI: 10.3760/cma.j.cn501225-20250220-00076.
shu

Selection strategies and progress of donor and recipient sites for vascularized lymph node transfer

doi: 10.3760/cma.j.cn501225-20250220-00076

  • Department of Reconstructive Microsurgery, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China

Funds:

Self-Funded Scientific Research Project of the Health Commission of the Guangxi Zhuang Autonomous Region Z-A20240798

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  • Corresponding author: Lan Rongyu, Email: book0597@163.com
  • Received Date: 2025-02-20
    Abstract
  • Lymphedema is a chronic and progressive disease resulted from the accumulation of protein-rich interstitial fluid in subcutaneous tissue and skin due to dysfunction of the lymphatic system. Lymphedema not only severely causes damage to the limb function of patients but also affects their mental health. Although there are many treatment methods available at present, it is difficult to completely improve long-term lymphedema. In recent years, vascularized lymph node transfer based on microsurgical techniques has become a research hotspot for the treatment of lymphedema and has been proven to be effective in reducing the volume of affected limbs and improving the quality of life of patients. However, there is still a lack of unified standards regarding the selection of donor site tissue flaps and the determination of recipient sites. This article starts with the selection strategies of donor and recipient sites for vascularized lymph node transfer, and reviews the latest research progress, aiming to provide evidence-based medical evidence for clinical practice and promote the standardized development of lymphedema treatment.

     

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  • [1]
    BrouillardP, WitteMH, EricksonRP, et al. Primary lymphoedema[J]. Nat Rev Dis Primers, 2021,7(1):77. DOI: 10.1038/s41572-021-00309-7.
    [2]
    夏林曦,马戈甲,王文飞,等. 肢体原发性淋巴水肿的外科治疗进展[J]. 组织工程与重建外科杂志,2025,21(1):83-87. DOI: 10.3969/j.issn.1673-0364.2025.01.015.
    [3]
    RocksonSG. Advances in lymphedema[J]. Circ Res, 2021,128(12):2003-2016. DOI: 10.1161/CIRCRESAHA.121.318307.
    [4]
    黄成,胡学庆. 淋巴水肿治疗的研究进展[J]. 组织工程与重建外科杂志,2022,18(1):38-41. DOI: 10.3969/j.issn.1673-0364.2022.01.009.
    [5]
    WardJ, KingI, Monroy-IglesiasM, et al. A meta-analysis of the efficacy of vascularised lymph node transfer in reducing limb volume and cellulitis episodes in patients with cancer treatment-related lymphoedema[J]. Eur J Cancer, 2021,151:233-244. DOI: 10.1016/j.ejca.2021.02.043.
    [6]
    CiudadP, HuayllaniMT, ForteAJ, et al. Vascularized lymph node transfer for the treatment of posttraumatic lower extremity lymphedema: a preliminary report[J]. Indian J Plast Surg, 2022,55(1):97-101. DOI: 10.1055/s-0041-1740520.
    [7]
    邓呈亮,陈君哲,肖顺娥,等. 基于算法浅谈继发性下肢淋巴水肿的外科整合治疗[J]. 中华烧伤与创面修复杂志,2025,41(6):516-524.DOI: 10.3760/cma.j.cn501225-20250217-00067.
    [8]
    JaffeHL, RichterMN. The regeneration of autoplastic lymph node transplants[J]. J Exp Med, 1928,47(6):977-980. DOI: 10.1084/jem.47.6.977.
    [9]
    ShesolBF, NakashimaR, AlaviA, et al. Successful lymph node transplantation in rats, with restoration of lymphatic function[J]. Plast Reconstr Surg, 1979,63(6):817-823.
    [10]
    BeckerC, HiddenG. Transfer of free lymphatic flaps. Microsurgery and anatomical study[J]. J Mal Vasc, 1988,13(2):119-122.
    [11]
    ChenHC, O'BrienBM, RogersIW, et al. Lymph node transfer for the treatment of obstructive lymphoedema in the canine model[J]. Br J Plast Surg, 1990,43(5):578-586. DOI: 10.1016/0007-1226(90)90123-h.
    [12]
    TobbiaD, SempleJ, BakerA, et al. Experimental assessment of autologous lymph node transplantation as treatment of postsurgical lymphedema[J]. Plast Reconstr Surg, 2009,124(3):777-786. DOI: 10.1097/PRS.0b013e3181b03787.
    [13]
    ClodiusL, SmithPJ, BrunaJ, et al. The lymphatics of the groin flap[J]. Ann Plast Surg, 1982,9(6):447-458. DOI: 10.1097/00000637-198212000-00001.
    [14]
    HonkonenKM, VisuriMT, TervalaTV, et al. Lymph node transfer and perinodal lymphatic growth factor treatment for lymphedema[J]. Ann Surg, 2013,257(5):961-967. DOI: 10.1097/SLA.0b013e31826ed043.
    [15]
    DayanJH, DayanE, SmithML. Reverse lymphatic mapping: a new technique for maximizing safety in vascularized lymph node transfer[J]. Plast Reconstr Surg, 2015,135(1):277-285. DOI: 10.1097/PRS.0000000000000822.
    [16]
    MeroniM, ScaglioniMF. Perforator-to-perforator SCIP-based vascularized lymphnode transfer to reduce morbidity and increase efficacy in lymphedema surgery: preliminary results with 12 cases[J]. Microsurgery, 2024,44(7):e31249. DOI: 10.1002/micr.31249.
    [17]
    ScaglioniMF, SuamiH. Lymphatic anatomy of the inguinal region in aid of vascularized lymph node flap harvesting[J]. J Plast Reconstr Aesthet Surg, 2015,68(3):419-427. DOI: 10.1016/j.bjps.2014.10.047.
    [18]
    SuamiH, O'NeillJK, PanWR, et al. Superficial lymphatic system of the upper torso: preliminary radiographic results in human cadavers[J]. Plast Reconstr Surg, 2008,121(4):1231-1239. DOI: 10.1097/01.prs.0000302511.21140.36.
    [19]
    BarreiroGC, BaptistaRR, KasaiKE, et al. Lymph fasciocutaneous lateral thoracic artery flap: anatomical study and clinical use[J]. J Reconstr Microsurg, 2014,30(6):389-396. DOI: 10.1055/s-0034-1372482.
    [20]
    CoroneosCJ, AsaadM, WongFC, et al. Outcomes and technical modifications of vascularized lymph node transplantation from the lateral thoracic region for treatment of lymphedema[J]. J Surg Oncol, 2022,125(4):603-614. DOI: 10.1002/jso.26783.
    [21]
    InbalA, TevenCM, ChangDW. Latissimus dorsi flap with vascularized lymph node transfer for lymphedema treatment: technique, outcomes, indications and review of literature[J]. J Surg Oncol, 2017,115(1):72-77. DOI: 10.1002/jso.24347.
    [22]
    PappalardoM, PatelK, ChengMH. Vascularized lymph node transfer for treatment of extremity lymphedema: an overview of current controversies regarding donor sites, recipient sites and outcomes[J]. J Surg Oncol, 2018,117(7):1420-1431. DOI: 10.1002/jso.25034.
    [23]
    ChengMH, HuangJJ, NguyenDH, et al. A novel approach to the treatment of lower extremity lymphedema by transferring a vascularized submental lymph node flap to the ankle[J]. Gynecol Oncol, 2012,126(1):93-98. DOI: 10.1016/j.ygyno.2012.04.017.
    [24]
    De SantisG, SaxenaB, StarnoniM, et al. Efficacy of vascularized submental lymph node transfer with decongestive therapy and antibiotics for early-stage lower limb filarial lymphedema[J]. Plast Reconstr Surg, 2023,151(5):850e-856e. DOI: 10.1097/PRS.0000000000010046.
    [25]
    ScaglioniMF, ArvanitakisM, ChenYC, et al. Comprehensive review of vascularized lymph node transfers for lymphedema: outcomes and complications[J]. Microsurgery, 2018,38(2):222-229. DOI: 10.1002/micr.30079.
    [26]
    AlthubaitiGA, CrosbyMA, ChangDW. Vascularized supraclavicular lymph node transfer for lower extremity lymphedema treatment[J]. Plast Reconstr Surg, 2013,131(1):133e-135e. DOI: 10.1097/PRS.0b013e318272a1b4.
    [27]
    ChungJH, HwangYJ, ParkSH, et al. Preliminary outcomes of combined surgical approach for lower extremity lymphedema: supraclavicular lymph node transfer and lymphaticovenular anastomosis[J]. J Plast Surg Hand Surg, 2022,56(5):261-269. DOI: 10.1080/2000656X.2021.1964980.
    [28]
    GoldsmithHS, De los SantosR. Omental transposition in primary lymphedema[J]. Surg Gynecol Obstet, 1967,125(3):607-610.
    [29]
    HirschTI, FriedmanR, GranoffM, et al. Omental vascularized lymph node transplant for the treatment of breast lymphedema: a case report[J]. Microsurgery, 2023,43(4):387-391. DOI: 10.1002/micr.31004.
    [30]
    NguyenAT, SuamiH, HanasonoMM, et al. Long-term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema[J]. J Surg Oncol, 2017,115(1):84-89. DOI: 10.1002/jso.24379.
    [31]
    CiudadP, MarucciaM, SocasJ, et al. The laparoscopic right gastroepiploic lymph node flap transfer for upper and lower limb lymphedema: technique and outcomes[J]. Microsurgery, 2017,37(3):197-205. DOI: 10.1002/micr.22450.
    [32]
    CoriddiM, WeeC, MeyersonJ, et al. Vascularized jejunal mesenteric lymph node transfer: a novel surgical treatment for extremity lymphedema[J]. J Am Coll Surg, 2017,225(5):650-657. DOI: 10.1016/j.jamcollsurg.2017.08.001.
    [33]
    KraftCT, EifermanD, JordanS, et al. Complications after vascularized jejunal mesenteric lymph node transfer: a 3-year experience[J]. Microsurgery, 2019,39(6):497-501. DOI: 10.1002/micr.30491.
    [34]
    KwiecienGJ, GharbBB, TadisinaKK, et al. Quantity of lymph nodes in the vascularized lymph node transfer influences its lymphaticovenous drainage[J]. J Reconstr Microsurg, 2018,34(1):41-46. DOI: 10.1055/s-0037-1606320.
    [35]
    GustafssonJ, ChuSY, ChanWH, et al. Correlation between quantity of transferred lymph nodes and outcome in vascularized submental lymph node flap transfer for lower limb lymphedema[J]. Plast Reconstr Surg, 2018,142(4):1056-1063. DOI: 10.1097/PRS.0000000000004793.
    [36]
    ChengMH, ChenSC, HenrySL, et al. Vascularized groin lymph node flap transfer for postmastectomy upper limb lymphedema: flap anatomy, recipient sites, and outcomes[J]. Plast Reconstr Surg, 2013,131(6):1286-1298. DOI: 10.1097/PRS.0b013e31828bd3b3.
    [37]
    TinhoferIE, MengS, SteinbacherJ, et al. The surgical anatomy of the vascularized lateral thoracic artery lymph node flap-a cadaver study[J]. J Surg Oncol, 2017,116(8):1062-1068. DOI: 10.1002/jso.24783.
    [38]
    TzouCH, MengS, InesT, et al. Surgical anatomy of the vascularized submental lymph node flap: anatomic study of correlation of submental artery perforators and quantity of submental lymph node[J]. J Surg Oncol, 2017,115(1):54-59. DOI: 10.1002/jso.24336.
    [39]
    GeretyPA, PannucciCJ, BastaMN, et al. Lymph node content of supraclavicular and thoracodorsal-based axillary flaps for vascularized lymph node transfer[J]. J Vasc Surg Venous Lymphat Disord, 2016,4(1):80-87. DOI: 10.1016/j.jvsv.2015.06.004.
    [40]
    BorchardF, BetzP. Number and size of perigastric lymph nodes in human adults without gastric cancer[J]. Surg Radiol Anat, 1991,13(2):117-121. DOI: 10.1007/BF01623884.
    [41]
    GustafssonJ, ChengMH. Reply: correlation between quantity of transferred lymph nodes and outcome in vascularized submental lymph node flap transfer for lower limb lymphedema[J]. Plast Reconstr Surg, 2019,143(4):897e-898e. DOI: 10.1097/PRS.0000000000005469.
    [42]
    PatelKM, ChuSY, HuangJJ, et al. Preplanning vascularized lymph node transfer with duplex ultrasonography: an evaluation of 3 donor sites[J]. Plast Reconstr Surg Glob Open, 2014,2(8):e193. DOI: 10.1097/GOX.0000000000000105.
    [43]
    LiuHL, ChungJC. The lymph node content of supraclavicular lymph node flap: a histological study on fresh human specimens[J]. Lymphat Res Biol, 2019,17(5):537-542. DOI: 10.1089/lrb.2018.0056.
    [44]
    DanielBW, SonnenbergAM, SternJE, et al. Intra-abdominal lymph node flaps in lymphedema therapy: an anatomical guide to donor site selection[J]. J Surg Oncol, 2022,125(2):134-144. DOI: 10.1002/jso.26705.
    [45]
    SchaverienMV, AsaadM, SelberJC, et al. Outcomes of vascularized lymph node transplantation for treatment of lymphedema[J]. J Am Coll Surg, 2021,232(6):982-994. DOI: 10.1016/j.jamcollsurg.2021.03.002.
    [46]
    GrünherzL, BarbonC, von ReibnitzD, et al. Analysis of different outcome parameters and quality of life after different techniques of free vascularized lymph node transfer[J]. J Vasc Surg Venous Lymphat Disord, 2024,12(6):101934. DOI: 10.1016/j.jvsv.2024.101934.
    [47]
    MyungY, ParkJK, BeomJ, et al. Outcome analysis of combined surgical approaches in advanced-stage upper extremity breast cancer-related lymphedema[J]. Plast Reconstr Surg Glob Open, 2023,11(9):e5237. DOI: 10.1097/GOX.0000000000005237.
    [48]
    KleinhansE, BaumeisterRG, HahnD, et al. Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels[J]. Eur J Nucl Med, 1985,10(7/8):349-352. DOI: 10.1007/BF00251310.
    [49]
    LiuHL, PangSY, LeeCC. Donor limb assessment after vascularized groin lymph node transfer for the treatment of breast cancer-related lymphedema: clinical and lymphoscintigraphy findings[J]. J Plast Reconstr Aesthet Surg, 2019,72(2):216-224. DOI: 10.1016/j.bjps.2018.10.013.
    [50]
    CiudadP, SabbaghMD, AgkoM, et al. Surgical management of lower extremity lymphedema: a comprehensive review[J]. Indian J Plast Surg, 2019,52(1):81-92. DOI: 10.1055/s-0039-1688537.
    [51]
    SekiY, KajikawaA, YamamotoT, et al. The dynamic-lymphaticovenular anastomosis method for breast cancer treatment-related lymphedema: creation of functional lymphaticovenular anastomoses with use of preoperative dynamic ultrasonography[J]. J Plast Reconstr Aesthet Surg, 2019,72(1):62-70. DOI: 10.1016/j.bjps.2018.09.005.
    [52]
    GarzaRM, BeedermanM, ChangDW. Physical and functional outcomes of simultaneous vascularized lymph node transplant and lymphovenous bypass in the treatment of lymphedema[J]. Plast Reconstr Surg, 2022,150(1):169-180. DOI: 10.1097/PRS.0000000000009247.
    [53]
    SeidenstueckerK, FertschS, GhazalehAA, et al. Improving quality of life after breast cancer: a comparison of two microsurgical treatment options for breast cancer-related lymphedema (BCRL)[J]. Clin Exp Med, 2024,24(1):82. DOI: 10.1007/s10238-024-01344-w.
    [54]
    肖一丁,龙笑. 脂肪抽吸术在治疗慢性晚期淋巴水肿中的应用[J]. 组织工程与重建外科杂志,2022,18(1):49-52. DOI: 10.3969/j.issn.1673-0364.2022.01.012.
    [55]
    郝昆,孙宇光,王仁贵,等. 抽吸减容术治疗乳腺癌术后上肢淋巴水肿[J]. 组织工程与重建外科杂志,2024,20(1):69-74,82. DOI: 10.3969/j.issn.1673-0364.2024.01.005.
    [56]
    BollettaA, di TarantoG, LoscoL, et al. Combined lymph node transfer and suction-assisted lipectomy in lymphedema treatment: a prospective study[J]. Microsurgery, 2022,42(5):433-440. DOI: 10.1002/micr.30855.
    [57]
    WintersH, TielemansHJP, HummelinkS, et al. DIEP flap breast reconstruction combined with vascularized lymph node transfer for patients with breast cancer-related lymphedema[J]. Eur J Surg Oncol, 2022,48(8):1718-1722. DOI: 10.1016/j.ejso.2022.05.007.
    [58]
    BurlageLC, WintersH, TielemansHJP, et al. Optimizing quality of life for patients with breast cancer-related lymphedema: a prospective study combining DIEP flap breast reconstruction and lymphedema surgery[J]. Plast Reconstr Surg, 2021,147(5):876e-877e. DOI: 10.1097/PRS.0000000000007807.
    [59]
    DionyssiouD, TsimponisA, GeorgiadouE, et al. Long-term results of lymphedema treatment with combined lymph node transfer and collagen scaffolds: an observational study[J]. JPRAS Open, 2025,43:328-339. DOI: 10.1016/j.jpra.2024.11.019.
    [60]
    RochlinDH, InchausteS, ZelonesJ, et al. The role of adjunct nanofibrillar collagen scaffold implantation in the surgical management of secondary lymphedema: review of the literature and summary of initial pilot studies[J]. J Surg Oncol, 2020,121(1):121-128. DOI: 10.1002/jso.25576.
    [61]
    SankaSA, ChryssofosS, AnolikRA, et al. Advances in surgical management of chronic lymphedema: current strategies and future directions[J]. Med Oncol, 2025,42(2):44. DOI: 10.1007/s12032-024-02576-2.
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