Plastic and reconstructive surgery · 2026
Prophylactic Surgery for Gynecologic Cancer-Related Lower Extremity Lymphedema.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Jeong Hyung Hwa, Kwon Jin Geun, Kim Tae Hyung, Suh HyunSuk Peter, Pak ChangSik John, Kim DaeYeon, Hong Joon Pio
Аннотация
BACKGROUND: Lower extremity lymphedema (LEL) is a frequent and debilitating complication following gynecologic cancer surgery. While prophylactic lymph node-to-vein anastomosis (LNVA) may offer a preventive strategy, its efficacy has not been well established.
METHODS: In this controlled study, 26 gynecologic cancer patients undergoing lymph node clearance received simultaneous prophylactic LNVA (prospective intervention group) from July 2022 to January 2024. A retrospective control group comprised 88 patients who underwent radical lymphadenectomy between April 2018 and February 2019. Patients were evaluated over an average of two-year follow-up using limb circumference, imaging-based measurements of subcutaneous thickness, and bioimpedance analysis to assess the incidence of LEL.
RESULTS: Baseline demographics were similar between the control group and the LNVA group, except for a higher proportion of patients who received adjuvant radiotherapy in the LNVA group and a higher cancer recurrence rate in the control group. At the one-year follow-up, the incidence of lymphedema was significantly lower in the LNVA group compared with the control group (8% vs. 49%; p<0.001). Additionally, the LNVA group exhibited minimal changes in limb volume and bioimpedance values during the one-year follow-up, suggesting preservation of lymphatic drainage.
CONCLUSIONS: Prophylactic LNVA performed concurrently with gynecologic cancer surgery was associated with a markedly reduced incidence of lower extremity lymphedema over an average of 2-year period. This preventive strategy may improve patient outcomes by mitigating LEL, a frequent and life-long complication of cancer treatment.
METHODS: In this controlled study, 26 gynecologic cancer patients undergoing lymph node clearance received simultaneous prophylactic LNVA (prospective intervention group) from July 2022 to January 2024. A retrospective control group comprised 88 patients who underwent radical lymphadenectomy between April 2018 and February 2019. Patients were evaluated over an average of two-year follow-up using limb circumference, imaging-based measurements of subcutaneous thickness, and bioimpedance analysis to assess the incidence of LEL.
RESULTS: Baseline demographics were similar between the control group and the LNVA group, except for a higher proportion of patients who received adjuvant radiotherapy in the LNVA group and a higher cancer recurrence rate in the control group. At the one-year follow-up, the incidence of lymphedema was significantly lower in the LNVA group compared with the control group (8% vs. 49%; p<0.001). Additionally, the LNVA group exhibited minimal changes in limb volume and bioimpedance values during the one-year follow-up, suggesting preservation of lymphatic drainage.
CONCLUSIONS: Prophylactic LNVA performed concurrently with gynecologic cancer surgery was associated with a markedly reduced incidence of lower extremity lymphedema over an average of 2-year period. This preventive strategy may improve patient outcomes by mitigating LEL, a frequent and life-long complication of cancer treatment.