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    Interventional procedure overview of lymphovenous anastomosis during axillary or inguinal node dissection for preventing secondary lymphoedema

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    Other relevant studies

    Other potentially relevant studies to the IP overview that were not included in the main evidence summary (tables 2 and 3) are listed in table 5.

    Table 5 additional studies identified

    Article

    Number of patients and follow up

    Direction of conclusions

    Reason study was not included in main evidence summary

    Boccardo F, Casabona F, DeCian F et al. (2014) Lymphatic microsurgical preventing healing approach (LYMPHA) for primary surgical prevention of breast cancer‐related lymphedema: Over 4 years follow‐up. Microsurgery, 34(6), 421-424

    N=78

    (Had LYMPHA, n=74)

    Follow up = 4 years

    4.05% LE incidence after LYMPHA compared with referenced rates of LE after sentinel lymph node biopsy of 6-13%, and axillary dissection alone of 13-65%.

    Included in systematic reviews.

    Feldman S, Bansil H, Ascherman J et al. (2015) Single institution experience with lymphatic microsurgical preventive healing approach (LYMPHA) for the primary prevention of lymphedema. Annals of surgical oncology, 22, 3296-3301

    N=37

    Median follow up = 6 months

    12.5% LE incidence rate in a high-risk cohort of patients

    Included in systematic reviews.

    Boccardo F, Valenzano M, Costantini S et al. (2016) LYMPHA technique to prevent secondary lower limb lymphedema. Annals of surgical oncology, 23, 3558-3563

    N=27

    (n=11 with vulvar cancer, n=16 with melanoma)

    6.25% (transient) LE incidence in the melanoma group (n=16) and 9% permanent LE incidence in the vulvar cancer group (n=11).

    Included in systematic reviews.

    Agrawal J, Mehta S, Goel A et al. (2018) Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) for Prevention of Breast Cancer-Related Lymphedema—a Preliminary Report. Indian Journal of Surgical Oncology, 9(3), 369-373

    N=35

    5.7% (transient) LE incidence

    Other studies included with greater sample sizes.

    Schwarz GS, Grobmyer SR, Djohan RS et al. (2019) Axillary reverse mapping and lymphaticovenous bypass: Lymphedema prevention through enhanced lymphatic visualization and restoration of flow. Journal of Surgical Oncology, 120(2), 160-167

    N=60

    (Had LVA, n=58)

    Median follow up= 11.8 months

    3.4% LE incidence

    Included in systematic reviews.

    Johnson AR, Kimball S, Epstein S et al. (2019) Lymphedema incidence after axillary lymph node dissection: quantifying the impact of radiation and the lymphatic microsurgical preventive healing approach. Annals of Plastic Surgery, 82(4S), S234-S241

    N=1,419

    (Had LYMPHA, n=48)

    Median follow up = 25.7 months

    Pooled estimate of LE incidence was 2.1% with LYMPHA compared with 14.1% in the control group (p=0.029).

    Included in systematic reviews.

    Cakmakoglu C, Kwiecien GJ, Schwarz GS et al. (2020) Lymphaticovenous bypass for immediate lymphatic reconstruction in locoregional advanced melanoma patients. Journal of Reconstructive Microsurgery, 36(04), 247-252

    N=22

    Follow up = up to 12 months

    4.5% LE incidence

    Other studies included with greater sample sizes.

    Johnson AR, Fleishman A, Granoff MD et al. (2021) Evaluating the impact of immediate lymphatic reconstruction for the surgical prevention of lymphedema. Plastic and reconstructive surgery, 147(3), 373e-381e

    N=97

    (Had ILR, n=32)

    Median follow up = 11.4 months

    12.5% transient and 3.1% permanent LE incidence

    Included in systematic reviews.

    Cook JA, Sasor SR, Loewenstein SN et al. (2021) Immediate lymphatic reconstruction after axillary lymphadenectomy: a single-institution early experience. Annals of Surgical Oncology, 28, 1381-1387

    N=33

    Mean follow up = 9 months

    9.1% transient and 6.1% permanent LE incidence

    Other studies included with greater sample sizes.

    Katz LM, Connolly EP, Choi JC (2022) Lymphatic Bypass in Patients Receiving Regional Nodal Radiation. International Journal of Radiation Oncology, Biology, Physics, 114(3), e32

    N=54

    (Had LYMPHA, n=27)

    25.9% LE incidence in both LYMPHA and control groups.

    Other studies included with greater sample sizes.