Upper
Extremity
Lymphedema
Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery
What Is Upper Extremity Lymphedema?
Breast cancer patients who underwent axillary lymph node dissection following radiotherapy are at a higher risk of developing extremity lymphedema – Breast Cancer-Related Lymphedema (BCRL), a condition that results in tissue swelling and liquid retention in the arms. While it is possible to manage the condition with some home care, surgery may be necessary to significantly improve an individual’s comfort and quality of life. Ming-Heui Cheng, MD, FACS, a pioneer in plastic microsurgery and internationally renowned lymphedema specialist, performs vascularized lymph node flap transfers on lymphedema patients whose symptoms have not improved or continue to worsen six months after they emerged.
Symptoms Of Lymphedema Of The Arm
The affected limb may develop inflammation, infection, adipogenesis, and fibrosis of the tissue. The protein-concentrated fluid that accumulates inside the interstitial tissue may further block or make the drainage of the lymph fluid less efficient or even create an obstruction. Lymphedema of upper extremity causes pain, heaviness, skin hyperkeratosis, fibrosis, discomfort when wearing certain clothes and jewelry, cosmetic problems and limitation of daily activities for patients. It is common for lymphedema patients to experience depression, due to physical discomfort, emotional distress and lower quality of life.
Anderson,
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Medical Center Specifications and Equipment
The operating room is equipped with Mitaka microscopes, of which there are only four in Taiwan. They have a resolution of up to 16 million pixels and can magnify 42 times optically. They are very suitable for the anastomosis of lymphatic vessels and veins of 0.5 mm and are often used in lymphatic venous anastomosis, such as preoperative evaluation and intraoperative evaluation of the permeability of sutures, making the operation more stable and safe.
Surgical Techniques
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Vascularized Lymph Node Flap Transfer, VLNT
In some cases, surgery may be performed to alleviate swelling and reduce symptoms. Dr. Cheng has developed a unique technique that involves lymph node transfer. During the procedure, Dr. Cheng transfers lymph node flap to distal recipient site – dorsal wrist in the upper extremity or ankle in the lower extremity.
淋巴結移植治療乳癌術後淋巴水腫
術前
術後 6 個月
術後 8 年
-
水腫2年
-
丹毒/蜂窩性組織炎2次
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上臂改善：82％
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下臂改善：35％
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上臂改善：82％
-
下臂改善：50％
淋巴結移植治療乳癌術後淋巴水腫
術前
術後 6 個月
術後 8 年
-
水腫2年
-
丹毒/蜂窩性組織炎2次
-
上臂改善：82％
-
下臂改善：35％
-
上臂改善：82％
-
下臂改善：50％
淋巴結移植治療乳癌術後淋巴水腫
術前
術後 3 個月
術後 8 年
-
水腫10年
-
丹毒/蜂窩性組織炎30次
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體重60 kg
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上臂改善：5 ％
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下臂改善：5 ％
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體重 59 kg ( 減少1kg )
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上臂改善：60 ％
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下臂改善：10 ％
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體重56 kg ( 減少4 kg )
淋巴結移植治療二期乳癌術後淋巴水腫
術前
術後 24 個月
-
水腫2年
-
丹毒/蜂窩性組織炎3次
-
體重67kg
-
上臂改善：80 ％
-
下臂改善：56 ％
-
體重64 kg(減少3 kg)
淋巴結移植治療乳癌術後淋巴水腫
術前
術後 3 個月
術後 42 個月
-
水腫2年
-
丹毒/蜂窩性組織炎3次
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上臂改善：25 ％
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下臂改善：15 ％
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上臂改善：90 ％
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下臂改善：90 ％
Patient Testimonials
Patient Testimonials
Lymphedema Treatment Testimony: Canadian Patient at A+ Surgery Clinic, Taipei, Taiwan"Video Content:
Lymphedema Treatment Testimony:In addition to excellent medical care, also enjoys Taiwanese cuisine
Mr. William from Australia
Recommended reading journal
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Vascularized groin lymph node transfer using the wrist as a recipient site for management of postmastectomy upper extremity lymphedema.
Lin CH, Ali R, Chen SC, Wallace C, Chang YC, Chen HC, Cheng MH.
Plast Reconstr Surg. 2009 Apr;123(4):1265-75
https://www.ncbi.nlm.nih.gov/pubmed/19337095 -
Vascularized groin lymph node flap transfer for postmastectomy upper limb lymphedema: flap anatomy, recipient sites, and outcomes..
Cheng MH, Chen SC, Henry SL, Tan BK, Lin MC, Huang JJ.
Plast Reconstr Surg. 2013 Jun;131(6):1286-98.
https://www.ncbi.nlm.nih.gov/pubmed/23714790 -
Outcomes of Lymphedema Microsurgery for Breast Cancer-related Lymphedema With or Without Microvascular Breast Reconstruction.
Engel H, Lin CY, Huang JJ, Cheng MH.
Ann Surg. 2017 Jun 7
https://www.ncbi.nlm.nih.gov/pubmed/28594742 -
Greater Omental Lymph Node Flap for Upper Limb Lymphedema with Lymph Nodes-depleted Patient.
Chu YY, Allen RJ Jr, Wu TJ, Cheng MH.
Plast Reconstr Surg Glob Open. 2017 Apr 25;5(4):e1288.
https://www.ncbi.nlm.nih.gov/pubmed/28507857 -
The Submental versus Groin Vascularized Lymph Node Transfer Flaps: A Head-to-Head Comparison of Surgical Outcomes for Breast Cancer Related Lymphedema
Ho OA, Lin CY, Cheng MH. Plast Reconstr Surg Glob Open. 2018 [Epub ahead of print]
Contact Dr. Cheng For A Consultation
If you have Breast Cancer Related Lymphedema and would like to know more about the most advanced treatments, contact Dr. Cheng. Internationally recognized as a leading lymphedema specialist, Dr. Cheng can discuss treatment options, based on your individual case. Dr. Cheng is a member of the American Society of Reconstructive Microsurgery and has performed numerous VLN surgeries on breast cancer survivors and other lymphedema patients.