Secondary lymphedema is a common side effect of breast cancer treatment, with significant impact on patients' physical and psychological well‐being. Conservative therapies are the gold standard treatment, however surgical options are becoming more popular. Lymphaticovenular anastomosis (LVA) is a supermicrosurgical procedure that aims to restore lymphatic flow by anastomosing damaged lymphatics to subcutaneous venules. We aimed to assess the effects of LVA on patients' limb volume and quality of life. Pre‐ and postoperative limb volumes and LYMQOL scores were collected for patients undergoing LVA for lymphedema secondary to breast cancer. Thirty‐seven patients underwent LVA. A significant reduction was seen in median excess limb volume postoperatively (13.3%‐6.6%, P < 0.005), with volumetric improvement seen in 78% of patients. Thirteen patients were able to discontinue compression garment use. Eighty‐six percent of patients reported improved quality of life postoperatively with median LYMQOL score increasing from 90 to 104 points (P < 0.005). LVA is a minimally invasive surgical option for patients with early stage lymphedema. It can lead to significant volumetric improvements and in select patients, freedom from compression therapy. LVA can also lead to significant improvements in quality of life, in particular patients' mood and perception of their appearance.
As survival from cancer continues to improve, greater importance is placed on quality of life after surgery. Lymphoedema is a common and disabling complication of cancer treatment. Lymphaticovenular anastomosis (LVA) is a supermicrosurgical treatment option for lower limb lymphoedema. The aim of this study was to assess the effectiveness of LVA in reducing limb volume and its effect on quality of life of patients with secondary leg lymphoedema following treatment for cancer, including gynaecological cancers. Methods Limb volume and patient rated quality of life were collected prospectively preoperatively and at every post-operative appointment in this case series. All patients Conclusions In selected patients with early stage lymphoedema secondary to cancer treatment, LVA offers a minimally invasive surgical option that can achieve significant volumetric and quality of life improvements.
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