Abstract: Bi-level Vascularized Lymph Node Transfer: More Effective Than Single Site?

ReSultS: The study included 228 patients. Lymphedema was diagnosed clinically in 170 subjects and confirmed by lymphoscintigraphy in 162 (117 primary lymphedema, 45 secondary); 58 patients were thought to have a condition other than lymphedema and all had negative lymphoscintigrams (95% sensitivity, 100% specificity). A subgroup analysis of the 8 patients with clinical lymphedema but negative lymphoscintigrams was performed: all had primary lymphedema. Four patients were male, 7 involved the lower extremity, and 3 had prior infections. Mean duration of disease prior to lymphoscintigraphy was 8 years (range 1 month to 32 years). Lymphedema type, duration of disease, and infection history were not different between patients with true positive and false negative lymphoscintigrams (p=0.5). Two patients with a false-negative result underwent repeat lymphoscintigraphy 2.5–3 years later and exhibited a positive study consistent with lymphedema.