Combined pedicled superficial circumflex iliac artery perforator (SCIP) flap with lymphatic tissue preservation and lymphovenous anastomosis (LVA) for defect reconstruction and lymphedema-lymphocele prevention in thigh sarcoma surgery: Preliminary results.
BACKGROUND
Sarcoma surgery often requires large tissue resection to be treated safely. When the tumor is localized in the groin and/or medial thigh, lymphocele and lymphedema are common complications because of the rich lymphatic network present there. The aim of this study is to share the outcome of seven patients who received defect reconstruction in this area with combined pedicled superficial circumflex artery perforator (SCIP) flap with lymphatic tissue preservation and lymphovenous anastomosis (LVA) for prevention of lymphatic complications.


PATIENTS AND METHODS
Seven patients who underwent surgical resection of sarcoma in the groin and/or adductors compartment received defect reconstruction with pedicled SCIP flap combined with LVA. For a better dead space obliteration, four of them also received an additional tissue flap: two pedicled deep inferior epigastric perforator flaps and two free anterolateral thigh flaps. Indocyanine green lymphography was performed in all cases to identify the lymphatic pathway, make the preoperative marking and check the patency of the anastomoses.


RESULTS
All seven patients were successfully treated reaching a good aesthetic result and a full range of motion. No immediate nor delayed complications such as lymphocele or lymphorrhea and early extremity lymphedema were observed during the follow up (range: 6-9 months; mean: 7.3) and no secondary procedures were required.


CONCLUSIONS
The combination of the pedicle SCIP lymphatic tissue transfer with LVA seems to be effective in preventing the development of lymphatic sequelae after large resections in the medial thigh.
['Scaglioni|Mario F|MF|https://orcid.org/0000-0001-5289-9140', 'Meroni|Matteo|M|', 'Fritsche|Elmar|E|', 'Fuchs|Bruno|B|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000714:Anastomosis, Surgical D005260:Female D006119:Groin D006801:Humans D007083:Iliac Artery D008208:Lymphatic System D042601:Lymphatic Vessels D008209:Lymphedema D008210:Lymphocele D008297:Male D008875:Middle Aged D061525:Perforator Flap D011183:Postoperative Complications D019651:Reconstructive Surgical Procedures D012509:Sarcoma D013848:Thigh
lymphovenous anastomosis LVA sarcoma surgery lymphedema SCIP flap