Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema.
A prospective study of 11 LVA procedures in 10 patients
with breast cancer related lymphedema and a critical review of the
Breast Cancer Res Treat. 2008 Feb 13
The incidence of breast cancer related lymphedema (BCRL) varies
between 7-35% depending on the combination of treatment modalities.
Early detection of BCRL is crucial in order to start an effective non-
operative treatment program. Because of the lack of prospective
research on this topic, this study was undertaken to prospectively
determine the effect of Lympho Venous Anastomosis (LVA) on BCRL and to review the current literature.
Study design and methods
Ten patients who were previously treated for breast cancer by surgery,
radiotherapy, and chemotherapy, and were unresponsive to 12-weeks of
non-operative treatment, underwent an LVA procedure (Degni-Cordeiro).
Objective measurements were gathered for circumferential measurement
and water volumetry, and quality of life. Various types of
lymphoscintigraphy were carried out pre-operatively and post-
operatively at 3 and 12 months. Treatment was embedded in a
Post-operative volume measurements initially showed a 4.8% reduction
of lymphedema at 3 months and a 2% reduction after one year. Various
scintigraphic parameters showed some improvement. Quality of life
questionnaires reported minimal improvement. Reviewing the literature,
only retrospective studies were found; these reported varying results
for LVA procedures. The selection of patients, classification of
lymphedema, indications and types of LVA, and additional therapeutic
options were heterogeneous, not comparable, and lacked a validated
method of effect-assessment.
Our results showed a minimal reduction in volume of lymphedema
following LVA; in the literature, there was no convincing evidence of
the success of LVA. Non-operative treatment and elastic stockings are
still preferred by most patients with lymphedema, especially in early
stages with few irreversible changes.
Lympho-venous anastomosis (LVA) - Microsurgery - Evidence-
based medicine - Lymphoscintigraphy - Inverse water volumetry - Review
- Breast cancer related lymphedema
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For additional information:
http://www.lymphedemapeople.com/wiki/do ... lymphedema
Complications of Breast Cancer Radiotherapy
http://www.lymphedemapeople.com/wiki/do ... diotherapy
Lymphedema Therapy and the Quality of Life for Breast Cancer Patients
http://www.lymphedemapeople.com/wiki/do ... r_patients
Arm and Leg Swelling After Cancer
http://www.lymphedemapeople.com/wiki/do ... ter_cancer
Lymphedema After Cancer - How Serious Is It?
http://www.lymphedemapeople.com/wiki/do ... ious_is_it
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