The Long-term Patency of Lymphaticovenular Anastomosis in Breast Cancer–Related Lymphedema. Issue 2 (February 2019)

• Record Type: Journal Article
• Authors: Winters, Harm; Tielemans, Hanneke J. P.; Verhulst, Arico C.; Paulus, Vera A. A.; Slater, Nicholas J.; Ulrich, Dietmar J. O.
• Is Part Of: Annals of plastic surgery. Volume 82:Issue 2(2019)
• Publication Date: 2019-02
• Subjects: breast cancer -- lymphaticovenular anastomosis -- lymphedema surgery -- lymphedema treatment -- patency; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000001674
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Background and Objectives: Lymphedema is a condition that can greatly affect patient's quality of life. Promising results have been described with lymphaticovenular anastomosis (LVA) in the treatment of lymphedema. It is currently unknown at what rate anastomoses remain functional after a longer follow-up. The aim of this study was to determine LVA patency at 1-year follow-up. Methods: Retrospective chart review was performed on patients who underwent LVA surgery. Patients who had indocyanine green lymphography performed at 12 months' follow-up after LVA were included in this study. Volume measurements were performed prior to surgery and at 6 and 12 months' follow-up. Patients quality of life was measured prior to surgery and at 6 months' follow-up. Results: Twelve patients met inclusion criteria. In total, 15 (56.5%) of 23 LVAs were considered patent. In 8 patients (66.7%), at least 1 patent LVA was visible. The volume difference between the healthy and affected arms decreased 32.3% on average. Quality of life increased with 1.4 points on average. Conclusions: This study is, to our knowledge, the first to evaluate long-term patency of LVA in upper limb lymphedema. Our study demonstrates that at least 56.5% of the anastomoses created are patent after 1-year follow-up.