Abstract
Introduction Secondary lymphedema negatively impacts the quality of life. Lympho-venous anastomosis
(LVA) has shown to attenuate lymphedema symptoms.
Objective The aim of the study is to evaluate the efficacy, patient satisfaction, and quality
of life following LVA for breast cancer–related lymphedema (BCRL) in the Indian setup.
Materials and Methods We conducted a prospective, nonrandomized, feasibility study at a single institute.
Sixteen patients with BCRL undergoing secondary LVA between May 2020 and December
2021 were included in the study. Volumetry was done preoperatively and then 6, 12,
and 18 months postoperatively. The Indian limb lymphedema scoring (ILLS) system questionnaire
and satisfaction scoring were done 1 year postoperatively.
Results Sixteen patients undergoing secondary LVA for BCRL were included in the study. The
preoperative mean difference in limb circumference volume was 804.41 ± 472.01. This
was reduced to 471.81 ± 292.216 mL at the 6-month follow-up (t = –6.6323; p ≤ 0.00001), 448.58 ± 255.93 (t = –5.5295; p = 0.00006) at 12 months, and 445.25 ± 345.78 (t = –6.8957; p ≤ 0.00001) at 18 months of follow-up. The mean volume difference between the two
limbs at 12 months post-LVA was 515.3144 ± 284.2007 mL (t = 1.9972; p = 0.1250) and 362.7957 ± 201.9709 mL (t = 0.1221; p = 0.4522). The number of LVAs did not show a statistically significant difference
in outcome with a volume difference of 515.3144 ± 284.2007 and 362.7957 ± 201.9709 mL
in groups with less than four and more than four anastomosis and a p-value of 0.1250 and 0.4522, respectively. Similarly, body mass index (BMI) and duration
of lymphedema did not show a statistically significant difference in outcome (p = 0.2648 and 0.2281, respectively). The mean total ILLS were 31.35 and 13.66 pre-
and postoperatively, respectively, showing a statistically significant improvement
in the quality of life, with a p-value of 0.00023.
Conclusion LVA significantly improves the quality of life and reduces limb volume, with stabilization
occurring at 18 months, and the number of anastomoses, patient's BMI, and lymphedema
duration did not affect volume reduction in our set of patients.
Keywords
lymphedema - breast cancer–related lymphedema - indocyanine green - lympho-venous
anastomosis - Indian limb lymphedema scoring system
