# Vascularized Lymph Node Transfer Surgery for Successful Resolution of Long-Standing Lower Limb Lymphedema With Charles Excision: A Case Report

## TL;DR

A 35-year-old man with long-term leg swelling was successfully treated using a new surgical method combining lymph node transfer and tissue removal.

## Contribution

The paper presents a successful case of vascularized lymph node transfer combined with Charles excision for chronic lymphedema.

## Key findings

- Vascularized lymph node transfer combined with Charles excision resolved long-standing lower limb lymphedema.
- Postoperative wound dehiscence was managed successfully, leading to satisfactory healing.
- The case highlights the potential of surgical intervention in managing refractory lymphedema.

## Abstract

Lymphedema, a chronic condition characterized by abnormal swelling resulting from impaired lymphatic drainage, poses significant challenges in clinical management, especially when conventional therapies prove ineffective. This case report elucidates the successful resolution of long-standing lower limb lymphedema in a 35-year-old male through innovative surgical interventions. Despite enduring symptoms for 15 years and undergoing various treatments without improvement, the patient achieved remarkable relief following vascularized lymph node transfer surgery combined with Charles excision. This multidisciplinary approach aimed to restore lymphatic function and alleviate tissue bulk, addressing the condition's functional and cosmetic aspects. Preoperative evaluations, including imaging studies confirming grade IV lymphedema, guided surgical planning and contributed to the successful outcome. Postoperatively, despite wound dehiscence, prompt management facilitated satisfactory wound healing, underscoring the importance of meticulous postoperative care. This case underscores the significance of surgical intervention in managing refractory lymphedema and emphasizes the need for tailored treatment strategies to optimize patient outcomes. Further research and clinical experience are warranted to refine surgical techniques and identify optimal patient selection criteria, advancing the management of this challenging condition.