Jørgensen MG, Toyserkani NM, Sørensen JA, et al.
Microsurgery. Date of publication 2017 Mar 28;volume ():.
1. Microsurgery. 2017 Mar 28. doi: 10.1002/micr.30180. [Epub ahead of print]
The effect of prophylactic lymphovenous anastomosis and shunts for preventing
cancer-related lymphedema: a systematic review and meta-analysis.
Jørgensen MG(1), Toyserkani NM(1), Sørensen JA(1).
Author information:
(1)Department of Plastic Surgery, Odense University Hospital, Denmark.
BACKGROUND: Lymphedema is one of the most dreaded side effects to any cancer
treatment involving lymphadenectomy. Progressed lymphedema is adversely complex
and currently there is no widely acknowledged curative treatment. Therefore
recent focus has shifted to risk reduction and prevention. It has been
hypothesized that bypassing lymphatic vessels to veins prophylactically, could
minimize the lymphatic dysfunction seen following lymphadenectomy.
METHODS: To investigate this possible future treatment modality, we performed a
systematic meta-analysis of studies treating patients with prophylactic
lymphovenous analysisstomosis (LVA) for the prevention of secondary lymphedema
following lymphadenectomy. A systematic search yielded 12 articles included in
the qualitative analysis and four of these were further eligible to be included
in the quantitative analysis.
RESULTS: We found that patients treated with prophylactic LVA had a significant
reduction in lymphedema incidence (Relative risk: 0.33, 95%CI: 0.19 to 0.56) when
compared to patients receiving no prophylactic treatment (P < 0.0001).
CONCLUSION: Prophylactic LVA in relation to lymphadenectomy shows promising
results, however because of the low number of eligible studies and method
heterogeneity between studies, there is an urgent need for uniformly high quality
studies, before the treatment can be concluded effective.
© 2017 Wiley Periodicals, Inc.
DOI: 10.1002/micr.30180
PMID: 28370317
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