Evidence map›Paper›PMID 40673745›Full record

SynthesisJournal of surgical oncology2025

Preventing Secondary Lymphedema: A Systematic Review and Meta-Analysis on the Efficacy of Immediate Lymphovenous Anastomosis.

Chandler Hinson, Matthew Sink, Dominic Henn, Douglas Sammer, Andrew Y Zhang, Jessica I Billig, Edward Chang, Andrei Odobescu

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Chandler HinsonDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.ORCID https://orcid.org/0000-0002-3834-3047
Matthew SinkDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Dominic HennDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Douglas SammerDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Andrew Y ZhangDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Jessica I BilligDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Edward ChangMD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-1067-9750
Andrei OdobescuDepartment of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundSecondary lymphedema is a debilitating condition following oncologic lymphadenectomy. Despite advancements in rehabilitation and microsurgical interventions, there is no cure for lymphedema. Performing a lymphovenous anastomosis (LVA) at the time of a regional node dissection has been purported to reduce the risks of secondary lymphedema; however, there are conflicting studies and no clear consensus about the routine use of LVA for preventing lymphedema after lymphadenectomy. The present study aims to perform a comprehensive review and meta-analysis on immediate LVA for the prevention of secondary lymphedema.

methodsA systematic review and literature search were performed using PubMed, Embase, Web of Science, and Cochrane databases. Studies evaluating primary or immediate LVA in oncologic surgery were included. Studies with a control group were included in the meta-analysis.

resultsOverall, 39 studies, including 3697 patients (1,722 LVA; 1975 control), met inclusion criteria. Seventeen of the studies were included in the meta-analysis. Pooled analysis across all studies revealed a secondary lymphedema incidence of 7.1% in the LVA cohort versus 35.0% in controls. Meta-analysis demonstrated a significant reduction in lymphedema risk with immediate LVA (RR: 0.31). Subgroup analysis confirmed strong protective effects in breast cancer patients (RR: 0.28) and a significant but lesser benefit in dermatologic malignancies (RR: 0.35).

conclusionBased on the current literature, immediate LVA at time of lymphadenectomy significantly reduces the risk of secondary lymphedema in patients undergoing oncologic treatment. Given these findings, patients undergoing multimodal oncologic treatment including radiation and surgical lymphadenectomy should be considered candidates for immediate LVA.

Indexed as

Anastomosis, SurgicalLymphatic VesselsLymphedemaLymph Node ExcisionPostoperative ComplicationsVeinsHumansimmediate lymphovenous anastomosislymphatic bypasslymphedemalymph node surgerymicrosurgeryoncologic reconstructionsupermicrosurgery

Identifiers

PMID40673745
PMCPMC12455550

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.