Tailored Charles’ procedure and vascularized lymph node transfer for advanced stage Klippel–Trenaunay syndrome
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Le résumé fourni par la source
BACKGROUND: Klippel-Trenaunay syndrome (KTS) is primarily managed for vascular and soft-tissue abnormalities, while treatment of associated lymphedema remains poorly described. This study outlines our protocol for advanced lower-extremity lymphedema using a combined modified Charles' procedure and vascularized lymph node transfer (VLNT). METHODS: KTS patients with International Society of Lymphology (ISL) stage III lower-limb lymphedema treated between 1999 and 2018 were retrospectively reviewed. All underwent a modified Charles' excisional procedure with Homans techniques and VLNT. Outcomes were assessed at least one year postoperatively, focusing on early complications and postoperative hospital admissions for residual disease or recurrent infections. RESULTS: Twenty-two patients (14 male, 8 female) with a mean age of 21 years (range, 4-41) were included. Average time since KTS diagnosis was 14 years (range, 3-26). VLNT donor sites included groin (18.2%), supraclavicular (31.8%), and gastroepiploic (50%). Mean hospital stay was 16 days (range, 14-39). Follow-up averaged 38 months (range, 27-45). Three minor complications occurred (one wound dehiscence, one infection, one bleeding), and flap survival was 100%. Annual hospital admissions for soft-tissue infections decreased from a preoperative mean of 3.5 to 1.2 postoperatively. Patients required an average of 3.5 additional procedures (range, 2-8) to remove residual hemangiolymphangioma. CONCLUSIONS: Lymphedema in KTS presents unique challenges and differs markedly from typical primary or secondary lymphedema. Effective management requires meticulous assessment and individualized planning. In this population, functional improvement is the main objective, and extensive debulking procedures combined with physiologic reconstruction may provide meaningful clinical benefit despite limited aesthetic outcomes. ARTICLE HIGHLIGHTS: In severe lymphedema of patients diagnosed with KTS, single excisional or physiological surgical treatment is insufficient to fight the totality of pathologic processes at work. A combination of varied techniques that act on different disease's features can achieve significantly better outcomes.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Tailored Charles’ procedure and vascularized lymph node transfer for advanced stage Klippel–Trenaunay syndrome
- Date Crossref
- 26/03/2026
- Éditeur
- Informa UK Limited
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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China Medical University Department of Plastic and Reconstructive Surgery pays non établi dans la noticeUniversité ou école supérieure
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Wyckoff Heights Medical Center Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Sapienza University of Rome Department of Surgery “P.Valdoni” pays non établi dans la noticeUniversité ou école supérieure
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Center for Clinical and Cosmetic Research pays non établi dans la noticeÉtablissement de santé
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Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari pays non établi dans la noticeÉtablissement de santé
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Arzobispo Loayza National Hospital Department of Plastic pays non établi dans la noticeÉtablissement de santé
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Austin-Weston Center for Cosmetic Surgery pays non établi dans la noticeInstitution
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Azienda Ospedaliera Policlinico di Bari Department of Plastic and Reconstructive Surgery pays non établi dans la noticeÉtablissement de santé
Department of Plastic and Reconstructive Surgery — China Medical University, Department of Surgery — Wyckoff Heights Medical Center et Department of Surgery “P.Valdoni” — Sapienza University of Rome, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.