Integration of perioperative reduction treatment with lymphaticovenular anastomosis for the management of lower extremity lymphedema

Aim: This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis (LVA) and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy for lymphedema.Methods: We conducted a retrospective chart review of 134 consecutive patients with lower extremity lymphedema who were treated with LVA. A total of 116 patients were included, and they were divided into two groups: patients who underwent perioperative reduction treatment (PORT) following LVA surgery (PORT group, 51 patients) and patients who underwent no additional perioperative intervention after LVA surgery (control group, 65 patients). PORT included compression therapy and remedial exercise. A total of 41 matched pairs were extracted after propensity score matching analysis. The edema reduction effect was compared between the two groups.Results: Patients who underwent PORT had a significantly higher edema reduction than those in the control group (reduction in lower extremity lymphedema index, 14.7 vs. 6.7; P = 0.03). No unfavorable complications related to PORT were observed in our cohort.Conclusion: It would be highly beneficial to combine reduction treatment in the early postoperative period after LVA surgery to maximize treatment outcomes