Evidence map›Paper›PMID 41396216›Full record

SynthesisBreast cancer research and treatment2025

Lymphovenous bypass for the treatment of secondary lymphedema: A meta-analysis of prospective outcomes.

Stav Brown, Yizhuo Shen, Felix J Klimitz, Meera Nair, Samira Glaeser-Khan, Valentina Shamoun, Bohdan Pomahac, Parisa Lotfi, Mehra Golshan, Siba Haykal

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Review
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

10 authors.

Stav Brown *Plastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA.
Yizhuo Shen *Plastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA.
Felix J KlimitzPlastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA.
Meera NairPlastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA.
Samira Glaeser-KhanPlastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA.
Valentina ShamounTemerty Faculty of Medicine - University of Toronto, Toronto, Canada.
Bohdan PomahacPlastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA.
Parisa LotfiRadiology and Biomedical Imaging Department, Yale School of Medicine, New Haven, CT, USA.
Mehra GolshanDivision of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Siba HaykalPlastic and Reconstructive Surgery Division, Department of Surgery, Yale School of Medicine, 330 Cedar St 06519, New Haven, CT, USA. siba.haykal@yale.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the increasing popularity of microsurgical techniques for the treatment of lymphedema, there is a lack of high-level, prospective, long-term data and standardized outcome metrics. The purpose of this study was to analyze the long-term outcomes of Lymphovenous Bypass (LVB) surgery throughout the past two decades.

methodsWe conducted a systematic review of PubMed, Embase, and Web of Science databases to identify prospective clinical trials investigating LVB for lymphedema treatment. Reported outcome data included limb volume measurements, number of cellulitis episodes, compression garment use, and the assessment of complications. For studies involving multiple procedures, only outcomes from the respective LVB cohorts were analyzed. Retrospective data analyses were excluded.

resultsEight prospective studies (2009-2023) were included in the meta-analysis, comprising a total of 431 patients undergoing LVB with a mean follow-up of 21.8 ± 7.7 months. An average of 3.4 ± 1.0 anastomoses were performed per patient. LVB was associated with a 14.26% mean reduction in limb volume (95% CI 6.63-21.88; p < 0.0001) at one-year, and 46.3% (95% CI 24.9%-69.1%; p < 0.01) reduction/discontinuation of compression therapy following surgery. Patients also reported subjective symptom relief and reduced cellulitis episodes.

conclusionsThis systematic review provides the most comprehensive synthesis to date of long-term outcomes following LVB surgery for lymphedema. The findings support LVB as a safe and effective microsurgical intervention, with consistent reductions in limb volume, cellulitis episodes, and reliance on compression therapy.

Indexed as

Lymphatic VesselsLymphedemaAnastomosis, SurgicalFemaleHumansProspective StudiesTreatment OutcomeBreast cancerLymphedemaLymphovenous bypass

Identifiers

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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.