Updated 25 October 2017

First lymph node transplant for cancer patient a success

After suffering from tremendous swelling, this patient is able to live a fairly normal life again, following his successful surgery.

A man suffering from advanced skin cancer and lymphoedema has received successful reconstructive surgery.

Surgeons at Life Vincent Pallotti Hospital successfully performed a novel vascularized lymph node transfer, a procedure done on small blood vessels to treat lymphoedema.

Lymphatic damage

Lymphoedema is a painful side effect of cancer and cancer treatment. This procedure is believed to be the first in South Africa.

Dr Conrad Pienaar, specialist plastic and reconstructive surgeon, said: “This painful condition may develop when cancer blocks lymph nodes or lymph vessels, or alternatively when cancer treatment such as surgery or radiotherapy removes lymph nodes or damages part of the lymphatic system.

"It develops when lymph fluid isn't able to drain in the normal way and is collected in an area of the body, causing severe swelling."

Swelling did not subside

Stephanus Van Wyk developed lymphoedema in his left arm following treatment for a malignant melanoma, an advanced skin cancer.

The severe swelling of his arm developed soon after her had surgery to remove the cancer. Despite standard treatments, the swelling caused by the lymphoedema did not subside.

"My arm was permanently swollen and painful and I had limited movement to carry out daily tasks,” said Van Wyk.

During the surgery, functioning lymph nodes were transplanted from the outer groin area into the wrist to treat the lymphoedema in Van Wyk's arm.

"The vascularised groin lymph node transfer surgery is done through an incision in the groin with the aid of loupe magnification, a tool which provides surgeons with an excellent view of the area being operated on.

"We then carefully dissected out the targeted lymph nodes, along with the veins and artery and some surrounding tissue.

"Thereafter, the lymph nodes were transferred to the wrist, where blood vessels were reconnected under microscopic magnification, using specialised micro-instruments and tiny stitches,” explains Pienaar.

A 'sponge' to drain excess fluid

Once the transplanted lymph nodes are reestablished, they act as a physiological "sponge" to drain the excessive lymphoedema fluid, and as a result, diverts this fluid to the venous system to be drained away.

Lymphoedema is a long-term chronic condition and the swelling can affect patients emotionally, physically and practically.

"Not everyone who has cancer or cancer treatment develops lymphoedema and wherever possible, doctors plan cancer treatment to try to avoid damage to the lymph nodes.

"For those who do suffer from lymphoedema, their quality of life is greatly affected. If lymphoedema patients, such as Mr van Wyk, are suitable candidates for the lymph node transplant surgery, it can significantly improve their daily quality of life," says Dr Clare Neser, Specialist Plastic and Reconstructive Surgeon.

"This was a painless procedure that has left me with a sense of relief. I am grateful that through the expertise of Dr Pienaar and Dr Neser and the technological innovations made available to patients at Life Vincent Pallotti Hospital, patients like myself can be treated and can look forward to leading a normal life," concluded Van Wyk.

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