Facial Lymphedema Following Head and Neck Tumor Resection: Preliminary Experience of Supermicrosurgical Treatment With LVA-Report of Three Cases.

Facial lymphedema (FL) is a potential complication following head-and-neck tumor (HNT) therapy. Conservative management is often difficult, and there is limited literature on surgical treatments for FL. This report presents three cases of FL treated with lymphaticovenular anastomosis (LVA).

Primary LYmphedema Multidisciplinary Approach in Patients Affected by Primary Lower Extremity Lymphedema.

: Primary lymphedema is a chronic condition caused by a developmental abnormality of the lymphatic system, leading to its malfunction. Various surgical options, including physiologic and excisional procedures, have been proposed. The aim of this study was to present a comprehensive algorithm for the treatment of primary lower extremity lymphedema: the Primary LYmphedema Multidisciplinary Approach (P-LYMA).

Innervated breast reconstruction: a narrative review of neurotization techniques and outcomes.

Background And Objective: While significant sensation recovery improvements in neurotized breasts following reconstruction have been reported, sensation testing methods and surgical techniques have been widely variable. This narrative review aims to summarize available literature on current neurotization practices and sensory recovery outcomes in patients undergoing innervated breast reconstruction.

Methods: A comprehensive literature search of PubMed Medline, Web of Science, and Embase was conducted to identify all studies reporting outcomes of neurotization in breast reconstruction surgeries.

The Value of a Co-surgeon in Microvascular Breast Reconstruction: A Systematic Review and Meta-analysis.

Using a co-surgeon model has been suggested to improve perioperative outcomes and reduce the risk of complications. Therefore, we evaluated if a co-surgeon model compared with a single microsurgeon model could decrease the surgical time, length of stay, rate of complications, and healthcare-associated costs in adult patients undergoing microvascular breast reconstruction (MBR). A comprehensive search was performed across PubMed MEDLINE, Embase, and Web of Science.

Surgical management of breast cancer-related lymphedema: a narrative review of contemporary practices.

Background And Objective: Breast cancer-related lymphedema (BCRL) represents a colossal burden in terms of health and patient-reported outcomes. Surgical management plays a prominent role in the psychological and physical well-being of women suffering from BCRL. Therefore, we performed a narrative review of the current surgical management of BCRL and analyzed the postoperative results.

The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications.

There is a literature gap regarding facial feminization surgery (FFS) access and coverage. Our goal is to compile information from previous studies and assess the current policy landscape for these surgeries in the US. We also explored why some policies do not cover them, identify states with better coverage, and determine the most covered procedures.

Efficacy of Combined Spinal-Epidural Anesthesia for Lower Extremity Microvascular Reconstruction.

Introduction: Some surgeons have raised concerns regarding the sympathectomy-like effect of epidural anesthesia during lower limb microvascular reconstruction. The combined spinal-epidural (CSE) anesthetic technique incorporates several benefits of spinal and epidural techniques in a single approach. The aim of this study was to analyze the postoperative outcomes of patients undergoing soft-tissue reconstruction of the lower limb by implementing the CSE anesthesia approach.

Cross-leg free flaps and cross-leg vascular cable bridge flaps for lower limb salvage: experience before and after COVID-19.

Background: Previous reports have evidenced the disruptive effect of the COVID-19 in microsurgical and reconstructive departments. We report our experience with cross-leg free flaps and (CLFF) and cross-leg vascular cable bridge flaps (CLVCBF) for lower limb salvage, technical consideration to decrease morbidity, and some structural modifications to our protocols for standard of care adapted to the COVID-19.

Methods: We retrospectively included consecutive patients undergoing reconstruction with CLFFs and CLVCBFs for lower limb salvage from January 2003 to May 2022.

Lymph Node Transfer and Neolymphangiogenesis: From Theory to Evidence.

Background: Vascularized lymph node transfer (VLNT) has proven to be a valuable treatment for patients with advanced stages of lymphedema. Although spontaneous neolymphangiogenesis has been advocated to explain the positive effects of VLNT, there is still a lack of supportive biological evidence. The aim of this study was to demonstrate the postoperative formation of new lymphatic vessels using histologic skin sections from the lymphedematous limb.

The medial sural artery perforator flap for retromolar trigone reconstruction: A multicenter case series.

Background: Retromolar trigone (RMT) cancer is a rare malignancy, which develops in a narrow area of the oral cavity. Surgical intervention requires wide excision and appropriate reconstruction usually with a free tissue transfer. Little has been published regarding the ideal microvascular reconstruction, mainly focusing on radial forearm and anterolateral thigh free flap.

Inexpensive Materials for Microsurgery in Middle- and Low-Income Countries.

With the continuous incorporation of new technologies and advancements in surgical technique, microsurgical procedures around the world have generated a higher success rate and innovative procedures are now possible. In this setting, limitations regarding accessibility and acquisition of medical resources and equipment for these types of operations may be difficult in developing countries. We believe the dexterities of surgeons go beyond the surgical technique, meaning that we are able to use everyday materials to re-create affordable solutions that can be used during surgery in a safe way.

Experimental Models and Practical Simulators for Supermicrosurgery: An Updated Systematic Review and Meta-Analysis.

Background: Supermicrosurgical simulators and experimental models promote test viability, a faster learning curve, technical innovations, and improvements of the surgical dexterities. The authors aimed to present a systematic review and meta-analysis of preclinical experimental models and simulation platforms used for supermicrosurgery.

Methods: An electronic search was conducted across the PubMed MEDLINE, Embase, Web of Science, and Scopus databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

The breast cancer-related lymphedema multidisciplinary approach: Algorithm for conservative and multimodal surgical treatment.

Background: Multiple surgical alternatives are available to treat breast cancer-related lymphedema (BCRL) providing a variable spectrum of outcomes. This study aimed to present the breast cancer-related lymphedema multidisciplinary approach (B-LYMA) to systematically treat BCRL.

Methods: Seventy-eight patients presenting with BCRL between 2017 and 2021 were included.

Breast reconstruction using the Latissimus Dorsi Flap and Immediate Fat Transfer (LIFT): A systematic review and meta-analysis.

Background: Despite several efforts have been made to increase the volume of the latissimus dorsi (LD) flap, few studies have reported the outcomes of LD flap and immediate fat transfer (LIFT) to restore a natural native breast appearance during the initial reconstructive procedure. The aim of this study was to report the different surgical techniques used when implementing LIFT for breast reconstruction and evaluate the postoperative outcomes.

Methods: A systematic search was conducted across PubMed, Embase, Web of Science, Ovid MEDLINE®, and Scopus.

Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis.

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure.

Minimally invasive harvest of the latissimus dorsi flap for breast reconstruction: A systematic review.

Background: Poor cosmetic results with oncoplastic and implant-based breast reconstruction have stimulated an interest in latissimus dorsi flap (LDF)-based reconstruction. We reviewed the surgical techniques and outcomes of the LDF harvested with minimally invasive surgery.

Methods: A systematic search was conducted across PubMed-MEDLINE, Web of Science, Scopus, and Ovid-MEDLINE(R).

Calf augmentation and volumetric restoration: A systematic review and meta-analysis.

Background: Because of the recent attention focused on the aesthetics of the leg, outcomes in the literature are under-reported and require further investigation. We summarized the available evidence on the surgical techniques to augment the volume and dimension of the calf based on clinical outcomes and satisfaction rates.

Methods: An electronic search was conducted across PubMed MEDLINE, Web of Science, Scopus, and Ovid MEDLINER(R) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

Gastroepiploic vascularized lymph node transfer for extremities' lymphedema: Is two better than one? A retrospective case-control study.

Single (SG-VLN) and double gastroepiploic vascularized lymph node transfer (DG-VLN) have shown promising results for the treatment of extremities' lymphedema. The literature search yields only few other cases describing outcomes following double VLN transfers, but no comparative studies have been produced so far. The aim of this study was to retrospectively examine and compare the effects of SG-VLN versus DG-VLN transfer.

Maximizing Safety and Optimizing Outcomes of Labiaplasty: A Systematic Review and Meta-Analysis.

Background: The considerable increase in labiaplasty requires plastic surgeons to be acquainted with the surgical techniques, their respective complications, and satisfaction rates. The authors conducted a systematic review of the available evidence on labia minoraplasty, looking at surgical techniques, clinical outcomes, and patient satisfaction.

Methods: A comprehensive search across PubMed, Web of Science, SCOPUS, and CochraneCENTRAL was performed through October of 2020.