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Background <p>Despite 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.</p> Methods <p>We 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.</p> Results <p>Eight 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&#xa0;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; <i>p</i> &lt; 0.0001) at one-year, and 46.3% (95% CI 24.9%-69.1%; <i>p</i> &lt; 0.01) reduction/discontinuation of compression therapy following surgery. Patients also reported subjective symptom relief and reduced cellulitis episodes.</p> Conclusions <p>This 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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年12月15日

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

摘要

Background

Despite 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.

Methods

We 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.

Results

Eight 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.

Conclusions

This 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.