Outcome of secondary LVA for lymphedema and lymphorrhea following sarcoma resection.

Karakawa R, Yoshimatsu H, Fuse Y, +6 more, Yano T.

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

In a retrospective review of 24 patients, secondary lymphaticovenous anastomosis (LVA) for lymphedema or refractory lymphorrhea after lower extremity soft tissue sarcoma resection was technically feasible and associated with reduced lymphatic drainage volume and limb circumference-based lymphedema measures.

What was studied

A retrospective review of 24 patients who underwent secondary LVA for postoperative lymphorrhea (n=16) or lymphedema (n=8) following lower extremity soft tissue sarcoma resection (2019-2024), assessing lymphedema outcomes via the lower extremity lymphedema (LEL) Index at 6 months and lymphorrhea outcomes via per-patient mean daily drainage volume (5-day averages before and after LVA), using Wilcoxon signed-rank tests for paired comparisons.

Key findings

In the lymphorrhea cohort (n=16), median per-patient 5-day mean daily drainage volume decreased from 250.0mL/day before LVA to 82.0mL/day after LVA; the abstract text is truncated before the exact p-value for this comparison.
Secondary LVA was described as technically feasible and associated with reductions in both lymphatic drainage volume and the circumference-based LEL Index in this population.
The authors note favorable lymphatic vessel morphology supported technical feasibility of LVA, but caution that the clinical outcome findings should be interpreted considering the retrospective design and small subgroup sizes (16 and 8 patients).

Clinical relevance

The findings suggest secondary LVA may be a feasible and effective option for managing refractory lymphorrhea and lymphedema after sarcoma resection in a lymphatically high-risk anatomic area, which may be relevant to reconstructive surgeons managing this challenging postoperative complication, though the authors themselves urge cautious interpretation.

Who should care

Plastic & Reconstructive Surgery

Limitations

Small retrospective study with small subgroup sizes (16 and 8 patients) without a control group, explicitly acknowledged by the authors as limiting the strength of the clinical outcome conclusions; the abstract text is truncated before the exact statistical significance of the key drainage volume finding.

Secondary lymphaticovenous anastomosis reduced lymphatic drainage and lymphedema measures after sarcoma resection in this small retrospective series, though the authors caution the findings need cautious interpretation given the small sample.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

Extensive resection of lower extremity soft tissue sarcoma (STS), particularly in lymphatically high-risk regions such as the medial thigh and groin, is frequently associated with postoperative lymphorrhea and secondary lymphedema. Although lymphaticovenous anastomosis (LVA) has emerged as a physiologic treatment for lymphatic dysfunction, evidence supporting its efficacy after STS resection remains limited. This study aimed to evaluate the outcomes of secondary LVA for lymphedema and refractory lymphorrhea following lower extremity STS resection.

Methods

A retrospective review was conducted by including patients who underwent secondary LVA for postoperative lymphorrhea or lymphedema after lower extremity STS resection between 2019 and 2024. Lymphedema outcomes were assessed from the changes in the lower extremity lymphedema (LEL) Index at 6 months after operation. For lymphorrhea, a per-patient mean daily drainage volume was calculated from 5 consecutive days before and after LVA; these patient-level values are summarized as median (interquartile range [IQR]). Wilcoxon signed-rank tests were used for paired comparisons.

Results

Twenty-four patients were included in this study. LVA was performed for lymphorrhea in 16 and for lymphedema in 8 patients. In the lymphorrhea cohort, the median per-patient 5-day mean daily drainage volume decreased from 250.0 mL/day before LVA to 82.0 mL/day after LVA (p < 0.01). In the lymphedema cohort, 6 patients had complete paired LEL Index data, and all 6 patients showed a decrease (median, 258.0 to 241.1 mL/day; exact two-sided p = 0.031). A total of 54 LVAs were performed, with a mean lymphatic vessel diameter of 0.65 mm; 83% of these vessels demonstrated ectasis.

Conclusions

Secondary LVA was technically feasible and associated with reductions in lymphatic drainage volume and the circumference-based LEL Index after extensive lower extremity STS resection. Favorable lymphatic vessel morphology supports the technical feasibility of LVA in this high-risk population; however, the clinical outcome findings should be interpreted by considering the retrospective design and small subgroup sizes.

DOI

10.1016/j.bjps.2026.07.037

PMID

42561503

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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