• Kyung-Chul Moon and In-Jae Yoon.
• Department of Plastic Surgery, Korea University College of Medicine, Seoul, South Korea.
• Medicine (Baltimore). 2021 May 14; 100 (19): e25871.

Rationale: Despite significant advances in microsurgical techniques, simultaneous vascularized lymph node transfer (VLNT) and lymphovenous anastomosis (LVA) surgeries may be effective for treatment of end-stage lymphedema. This case report describes the successful treatment of end-stage lymphedema with VLNT and LVA.Patient ConcernsA 72-year-old patient with bilateral lower extremity lymphedema was referred to our lymphedema clinic. This patient had a history of lymphoma and treated with radiotherapy on right inguinal area 26 years ago. Interestingly, the patient developed lymphedema on both the right and left lower extremities although she had radiotherapy on her right inguinal area.DiagnosisAccording to the indocyanine green lymphography, lymphoscintigraphy, and magnetic resonance lymphangiography, the patient was diagnosed with end-stage lymphedema (International Society of Lymphology stage 3).InterventionThe patient underwent simultaneous VLNT and LVA for treatment of end-stage lymphedema.OutcomesSignificant reduction in circumference and volume of lower extremity was achieved following simultaneous VLNT and LVA.LessonsSimultaneous VLNT and LVA surgeries may be effective in patients with end-stage lymphedema.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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