Objectives
The current review showed that the efficacy of lymphovenous anastomosis (LVA) for the treatment of BCRL was promising and effective in early-stage BCRL. However, according to the international society of lymphology (ISL) criteria, stage II (late) or stage III BCRL suggested that LVA should be combined with surgery including vascularized lymph node flap transfer (VLNT) and liposuction since its’ diffuse pattern of indocyanine green (ICG) lymphography was considered as a poor superficial lymphatic function and fibrotic tissue around that renders LVA could be failed to conduct. This study aimed to evaluate outcome whether LVA alone benefits for stage II (late) or stage III BCRL.
Material and Methods
LVA was performed on 30 cases of BCRL that all ICG lymphography reveal the diffuse pattern of dermal backflow (DB) preoperatively, and 3 of 30 patients who had either VLNT or previous LVA before the LVA. The circumferential measurements were taken along the wrist, forearm, elbow, and upper arm at regular intervals. Absolute circumference change > 2 cm or relative circumference change ratio > 20% at 1 or 2 points was defined effective post LVA during the follow-up period.
Results
All patients received 1-8(M= 4.0) anastomosis shunts and maximum decrease of absolute circumference change 2-9 cm (M= 4.26) that were performed on each upper extremity within 6 hours surgical time. 27/30 (90%) patients benefited from LVA results.
Conclusions
LVAs are considered as an effective therapy at treating stage II (late)-stage III BCRL, and the indication for LVA should be reconsidered to be included.