Background: Lymphedema is characterized by accumulation of lymphatic fluid in a given body part. Lympho vascular transplant surgery has now become one of the main modalities in the treatment. There is however no consensus on the ultimate donor
sites. We share our experience with vascularized lymph node transplant surgery with nodes gotten from two different anatomical locations in the neck.
Objective: To determine the outcome of patients managed by vascularized lymph node transplant surgery with lymphovascular tissues from sub-mandibular and
supraclavicular donor sites.
Methodology: This was a comparative study of patients managed by lymphovascular tissue transplant in Kenyatta National Hospital, a tertiary hospital in Kenya between January 2013 and December 2023. All patients had lymphoscintigraphy done to confirm the diagnosis of lymphoedema .Patients were divided based on lymph node donor sites ; one group (SMN ) and the supraclavicular group (SCN) The limb girths were taken prior to surgery and then followed up at regular interval for at least one year. Variables considered in the study were the length of surgery, number of nodes harvested, reduction in the limb girth and complications. Results: A total of 44 patients were seen with 24 patients in SMN and 20 in SCN. The age range for the patients were 13 to 67 years with a mean age of 36 .6 years. The mean time for harvesting the nodes in the SCN was 3 hours 19 minutes while the SMN was 2 hours 14 minutes. There were more nodes harvested from the SMN compared to the SCN group though the difference was not statistically significant.
Conclusion: Both donor sites are effective in the management of lymphedema. However there is significant reduction in the operative time with the submandibular group of nodes due to a more consistent anatomical location of the blood vessels.