Efficacy of Lymphaticovenular Anastomosis for Secondary Upper Extremity Lymphedema: Treatment Strategies with Effects of Compression Therapy Discontinuation and Site-Specific Evaluation of the Upper Extremity
Publication: Lymphatic Research and Biology
Volume 21, Issue Number 6
Abstract
Background: Lymphaticovenular anastomosis (LVA) has recently become a mainstream surgical treatment for lymphedema and is a useful treatment option in addition to conservative therapies such as compression therapy, exercise therapy, and lymphatic drainage. We performed LVA with the goal of stopping compression therapy and report the effect of LVA on secondary lymphedema of the upper extremities.
Methods and Results: The participants were 20 patients with secondary lymphedema of the upper extremities categorized as stage 2 or 3 according to the International Society of Lymphology classification. We measured and compared the upper limb circumference at six locations before and 6 months after LVA. Significant decreases in circumference after surgery were observed at 8 cm proximal to the elbow, the elbow joint, 5 cm distal to the elbow, and the wrist joints, but not at 2 cm distal to the axilla or the dorsum of the hand. At more than 6 months postoperatively, eight patients who had been wearing compression gloves were no longer required to wear them, and three patients who had been wearing both sleeves and gloves were no longer required to wear them.
Conclusions: LVA is effective in the treatment of secondary lymphedema of the upper extremities, particularly in improving elbow circumference, and is one of the treatments that contributes significantly to the improvement of quality of life. For severe cases with limited range of motion of the elbow joint, LVA should be performed first. Based on these results, we present an algorithm for upper extremity lymphedema treatment.
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Information & Authors
Information
Published In
Lymphatic Research and Biology
Volume 21 • Issue Number 6 • December 2023
Pages: 574 - 580
PubMed: 37252768
Copyright
Copyright 2023, Mary Ann Liebert, Inc., publishers.
History
Published online: 22 December 2023
Published in print: December 2023
Published ahead of print: 26 May 2023
Authors
Authors' Contributions
E.H., S.O., and T.S. contributed to the study design. E.H. and S.O. contributed to the writing and revision of the article. E.H. performed surgery and data analysis.
Author Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received for this article.
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