Abstract
Background and Objectives: Lymphedema is an important and underestimated condition, and this progressive chronic disease has serious implications on patients’ quality of life. The main goal of research would be to prevent lymphedema, instead of curing it. Patients receiving radiotherapy after lymph node dissection have a significantly higher risk of developing lymphedema. Through the prophylactic use of microsurgical lymphaticovenular anastomoses in selected patients, we could prevent the development of lymphedema. Materials and Methods: Six patients who underwent prophylactic lymphaticovenular anastomoses in a distal site to the axillary or groin region after axillary or inguinal complete lymph node dissection followed by radiotherapy were analyzed. Patients characteristics, comorbidities, operative details, postoperative complications and follow-up assessments were recorded. Results: Neither early nor late generic surgical complications were reported. We observed no lymphedema development throughout the post-surgical follow-up. In particular, we observed no increase in limb diameter measured at 1, 3, 6 and 12 months postoperatively. Conclusion: In our experience, performing LVA after axillary or groin lymphadenectomy and after adjuvant radiotherapy, and distally to the irradiated area, allows us to ensure the long-term patency of anastomoses in order to obtain the best results in terms of reducing the risk of iatrogenic lymphedema. This preliminary report is encouraging, and the adoption of our approach should be considered in selected patients.
Highlights
Publisher’s Note: MDPI stays neutralThe lymphatic system plays an important homeostatic role in the immune system, lipid metabolism and fluid balance [1]
The purpose of our study was to investigate the efficacy of performing prophylactic lymphaticovenular anastomoses after axillary or inguinal complete lymph node dissection followed by radiotherapy
The time between lymph node dissection and lymphaticovenular anastomoses (LVA) was a minimum of 85 days, and a maximum of 130 days, with a median of 1085 days
Summary
The lymphatic system plays an important homeostatic role in the immune system, lipid metabolism and fluid balance [1]. The obstruction of the lymphatic flow, clinically manifested as lymphedema, can be caused by various conditions, such as infections, congenital malformations, traumatic injuries, surgical intervention sequelae or malignancies [2]. Secondary lymphedema, excluding the hereditary one, is an important and underestimated condition; this progressive chronic disease has serious implications on patients’. It is often misdiagnosed, and it is frequently associated with severe morbidity and disability, affecting daily activities and causing long-term health, functional, aesthetic and economic impacts [3]. The management of lymphedema is historically focused on a conservative approach that includes physical therapy, such as manual lymphatic drainage and compression garments Patients are prone to develop recurrent infections, which may show as cellulitis, erysipela or lymphangitis, often requiring hospitalization [4].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
