Today is my one year anniversary of my LNT-lymph node transfer surgery that Dr. Kline, Charleston, SC did during my Stage 2 natural breast reconstruction surgery.

HappyTrisha,

Yes, Dr Kline took nodes from groin on opposite side. It was actually a mini flap with nodes and artieries that needed to be anastomized (sewn/connected) to artery in axilla. There was no skin paddle like you see in natural breast reconstruction. The scar from the donor site is very faint now. However, the scar at transfer site in axilla was still noticeable in some tank tops this summer. Probably because he has had to work so many times on that ugly radiated side in stages. At post-op appointment of my most recent surgery #10 last month (which was fat grafting only and first time no drains-yay!), he told me that he would not work on my rads breast anymore until July 2015 because each time they go into that area they are disturbing the lymphatics/nodes and they need more time to grow.

If having LNT surgery alone it would be about 2.5 hours but mine was 7 as it was combined with stage 2 breast recon SGAP surgery. A PT-CLT wrapped my arm in hospital before and after surgery. My vessels were challenging as he said smallest ever to sew together and used thinnest suture thread on market. It should be a breeze for other patients having LNT only.

Helen, Thanks for sharing this blog. Looking forward to part three. 

PinkHeart! Hurray!!! I am SO happy for you! And Helensamia - thank you for sharing that link! I continue to fight my insurance on VLNT. I have gone all the way up the chain of command (to the people who actually wrote the policy - the hospital is self funded so they do pretty much whatever they want) and am now just waiting... So it is really, really good to hear some success stories, even if my opportunity to have it done may only be a dream.

Wow! Finally a published study on the efficacy of surgery for LE. Dr. Chang is a professor of plastic surgery at MD Anderson. 89 women with UE LE is a small number but this is encouraging!

I used Google Scholar and typed in "A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema. " and the first entry it returned was the full article in pdf format which I could open. It was a prospective study without any controls. Participants were instructed to wear the garments and continue their previous compression therapy (does this mean MLD?) at 4 weeks post op. An LE therapist used a Perometer to perform a circumference measurement every 0.5 cm to calculate the total volume of the limb. The volume measurements were performed 3 times and the average of these 3 volume measurements was used. The article does indicate how many LETs were involved in obtaining the measurements nor is the post op LE care made uniform for all of the participants. There were NO incidents of LE becoming worse after surgery and with UE LE a significant percent of women with Stage 1 and 2 LE had a measurable improvement. There was a less significant improvement in Stage 3 and 4 LE extremities. The article seems to indicate that women were required to continue to wear garments after the surgery.

Seeing this article published gives me hope, it means that there are physicians who are willing to collect scientific data and report it which takes some of the mystery out of these procedures. No doubt, more studies and participants are needed.

I'm a bit cynical about the lack of research to support the various surgical solutions, and as Binney points out, there are many variables that can obscure results. The answer to the 'variables' problem is to do lots more rigorous and robust research, with carefully defined measurement and treatment protocols, etc., and with long-term patient followup. But I SO agree with toomuch that it is heartening to see some research.  I hope that these and any other brave surgeons willing to put their pioneering work out for the medical, research and patient communities to review will spur others to jump on the research bandwagon.

Glad to hear PinkHeart that your LNT has gone well... Also HappyTrisha that you have an appointment with Dr Chang and I look forward to hearing how your Lymphasyntagraph goes... Good luck.. 

hey Happy Tricia and/or Pink Heart: I live in Chicago near OHare airport and would be happy to put you up in our guest room if/when you see Dr Chang.  I am planning on the bypass surgery in the fall (Nov) 

well hi 2 u all , it's
been 18 months since my LNT surgery at my left leg , done by the amazing Dr.
Corrine Becker , it has been an
amazing 18 months health wise , my leg is doing better every day , the swelling
in my feet is getting smaller each day that passes , according to an Mr Lymphografy
and MRI that I've done lately , it seems
that my new transplanted lymph nodes are alive and well , and are growing each
month new lymph vessels , in the MRI , u can see the transplanted nodes
and also  see the new vessels that are growing from them , by the looks of
things and from what Dr. Becker told me , I'm on the right track of getting
better , I do believe , as for Dr Becker as well, that with each month that
passes , I will see and feel a great release in the swelling

from appearance
only , I can honestly say(supported by my Dr. and physiotherapist) that my leg actually
starts looking like a normal organ again ,for me , since I have primary lymphedema
since I was 12 , which is about 20 years of having lymphedema , this is an actual
living miracle send from above , of course I have to emphasize that alongside
the surgery , I  still maintain doing Manuel lymph drainage every day , and I sleep with bandages all
night long , of course I ware elastic
stocking during day time , I am sure that with time , the leg will keep getting
better and better and hope that one day I can actually be elastic stocking free
, in Hebrew theres a saying "ashray ha maamin" which means " good things
happens to the ones that never stop believing"

will keep u posted about my advancement , wishing u all good health, Natalie

hi
helensamia , with me, the lymphedema is only on my left calves and feet. my
thigh , gladly, do not have lymphdema.

I also have some fibrous tissue that I work
very hard each day to try and soften it , since I do Self Manuel lymph drainage
every day and bandage my legs during day and night , my leg is better , I do recommend
each patient that went under LNT surgery , to try and also bandage his legs during
night time (after doing MLD) , it will be worth all the hard work , u
will see some amazing results . about the MRL , we also dont have that
exam in Israeli hospital , but since Paris is only 4 hours away by plain , a
year after the surgery I flew to meet dr becker and to have that exam done . i do hope u will get to see some amazing results with time, natalie