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Onishi et al. Plast Aesthet Res 2021;8:50 Plastic and
DOI: 10.20517/2347-9264.2021.75
Aesthetic Research

Original Article Open Access

Integration of perioperative reduction treatment with
lymphaticovenular anastomosis for the management

of lower extremity lymphedema

2
1
1
Fumio Onishi , Wataru Tsugu , Nanae Okuda , Toshiharu Minabe 1
1
Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama 3508550, Japan.
2
Nursing Department, Tochigi Cancer Center, Utsunomiya, Tochigi 3200834, Japan.
Correspondence to: Assoc. 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, Tsugu W, Okuda N, Minabe T. Integration of perioperative reduction treatment with
lymphaticovenular anastomosis for the management of lower extremity lymphedema. Plast Aesthet Res 2021;8:50.
https://dx.doi.org/10.20517/2347-9264.2021.75
Received: 24 Jun 2021 First Decision: 14 Jul 2021 Revised: 23 Jul 2021 Accepted: 3 Aug 2021 Published: 11 Sep 2021

Academic Editor: Matthew L Iorio Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Aim: This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis (LVA) and
perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy
for lymphedema.

Methods: We conducted a retrospective chart review of 134 consecutive patients with lower extremity
lymphedema who were treated with LVA. A total of 116 patients were included, and they were divided into two
groups: patients who underwent perioperative reduction treatment (PORT) following LVA surgery (PORT group, 51
patients) and patients who underwent no additional perioperative intervention after LVA surgery (control group,
65 patients). PORT included compression therapy and remedial exercise. A total of 41 matched pairs were
extracted after propensity score matching analysis. The edema reduction effect was compared between the two
groups.

Results: Patients who underwent PORT had a significantly higher edema reduction than those in the control group
(reduction in lower extremity lymphedema index, 14.7 vs. 6.7; P = 0.03). No unfavorable complications related to
PORT were observed in our cohort.

© The Author(s) 2021. 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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