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Onishi et al. Plast Aesthet Res 2024;11:5 Plastic and
DOI: 10.20517/2347-9264.2023.102
Aesthetic Research

Original Article Open Access

Early lymphaticovenous anastomosis in
lymphedema management: a pilot study

1,2
2
3
Fumio Onishi , Hayato Nagashima , Nanae Okuda , Toshiharu Minabe 1
1
Department of plastic surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama 350-8550, Japan.
2
Division of plastic and reconstructive surgery, Tochigi Cancer Center, Utsunomiya, Tochigi 320-0834, Japan.
3
Nursing department, Tochigi Cancer Center, Utsunomiya, Tochigi 320-0834, Japan.
Correspondence to: Prof. Fumio Onishi, Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University,
1981 Kamoda, Kawagoe, Saitama 350-8550, Japan. E-mail: foonishi@saitama-med.ac.jp
How to cite this article: Onishi F, Nagashima H, Okuda N, Minabe T. Early lymphaticovenous anastomosis in lymphedema
management: a pilot study. Plast Aesthet Res 2024;11:5. https://dx.doi.org/10.20517/2347-9264.2023.102

Received: 31 Oct 2023 First Decision: 28 Dec 2023 Revised: 14 Jan 2024 Accepted: 23 Jan 2024 Published: 26 Jan 2024
Academic Editor: Tine Engberg Damsgaard Copy Editor: Dan Zhang Production Editor: Dan Zhang

Abstract
Aim: Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.
Conservative and surgical treatments, such as lymphaticovenous anastomosis (LVA), are available; however, the
optimal timing for LVA after the initiation of complex decongestive therapy (CDT) remains unclear. This study
aimed to evaluate the effect of CDT duration prior to LVA on the treatment outcomes of upper extremity
lymphedema.

Methods: Fifty patients with stage II upper extremity lymphedema who underwent LVA were retrospectively
evaluated. Patients were divided into two groups based on the duration of CDT before LVA: < 6 months (early
group) and > 6 months (non-early group). The primary outcome measures were percent excess volume (PEV) and
reduction rate 12 months after LVA.

Results: The early group (CDT < 6 months) showed significantly better outcomes than the non-early group
(CDT > 6 months). The early group had a lower PEV (4%) and a higher reduction rate (56%) than the non-early
group (PEV of 10% and reduction rate of 25%) at 12 months after LVA.

Conclusions: Early indication for LVA (within 6 months of CDT initiation) resulted in better treatment outcomes for
stage II upper extremity lymphedema. This study highlights the potential benefits of early surgical intervention for
improving the prognosis of lymphedema.

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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