ArticleJournal of vascular surgery. Venous and lymphatic disorders2024
Supermicrosurgery lymphaticovenous and lymphaticolymphatic anastomosis: Technical detail and short-term follow-up for immediate lymphatic reconstruction in breast cancer treatment-related lymphedema prevention.
Article in Journal of vascular surgery. Venous and lymphatic disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.
- Immediate Lymphatic Reconstruction (ILR) for the Prevention of Lymphedema: A Meta-analysis of Prospective Clinical Trials.Annals of surgical oncology · 2026Pooled it
- Efficacy of Immediate Lymphatic Reconstruction in Prevention of Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis.Microsurgery · 2025Pooled it
- Breast cancer-related lymphedema of the upper limb: integrating early surveillance and functional surgery into a synergistic management paradigm.Frontiers in surgery · 2026Review
- Review
- BJS commission on the surgical management of the axilla in breast cancer.The British journal of surgery · 2025Article
- Immediate lymphatic reconstruction (ILR) for prevention of secondary lymphedema after breast cancer surgery: a systematic review and meta‑analysis.Gland surgery · 2025Article
- Modern approaches to lymphatic surgery: a narrative review.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Review
- Advances in etiology, pathophysiology, diagnosis, and management of lymphedema: a comprehensive review.Frontiers in medicine · 2025Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe describe the feasibility and short-term outcome of our surgical technique to repair the lymph vessel disruption directly after axillary lymph node dissection during breast cancer surgery. This procedure is called immediate lymphatic reconstruction to prevent breast cancer treatment-related lymphedema (BCRL), which frequently occurs after axillary lymph node dissection. The surgical technique consisted of lymphaticovenous anastomosis (LVA) or lymphaticolymphatic anastomosis. We named the procedure lymphatic bypass supermicrosurgery (LBS).
methodsThis study used a retrospective cohort design of patients with breast cancer between May 2020 and February 2023. LBS was performed by making an intima-to-intima coaptation between afferent lymph vessels and the recipient's veins (LVA) or efferent lymph vessels lymphaticolymphatic anastomosis.
resultsA total of 82 patients underwent lymphatic bypass. The mean age of patients was 50 ± 12 years, and most had stage III breast cancer (n = 59 [72%]). LVA was the most common type of lymphatic bypass (94.6%). The median number of LVA was 1 (range, 1-4) and 1 (range, 1-3) for lymphaticolymphatic anastomosis. The median follow-up time was 12.5 months (range, 1-33 months). The 50 patients who had postoperative indocyanine green lymphography described arm dermal backflow stage 0 in 20 (40%), stage 1 in 19 (38%), stage 2 in 2 (4%), and stage 3 in 9 (18%) cases. The proportion of BCRL was 11 (22%), and subclinical lymphedema was 19 (38%) in this period. Most cases were in stable subclinical lymphedema (10, 58.8%). The 1-year and 2-year BCRL rates were 14% (95% confidence interval, 4%-23.9%) and 22% (95% confidence interval, 10.1%-33.9%), respectively.
conclusionsAlong with the emerging immediate lymphatic reconstruction, LBS is a feasible supermicrosurgery technique that may have a potential role in BCRL prevention. A randomized controlled study would confirm the effectiveness of the technique.
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