Early lymphaticovenous anastomosis in lymphedema management: a pilot study

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.