Lymphovenous Bypass Procedure for Secondary Prevention of Lymphedema in Breast Cancer

Effectiveness of Lymphovenous Bypass Procedure for Secondary Prevention of Lymphedema in Breast Cancer

This study aims to evaluate the effectiveness of the Lymphovenous Bypass (LVB) procedure compared to physiotherapy alone as secondary prevention of lymphedema in breast cancer patients undergoing axillary lymph node dissection.

In the intervention group, LVB was performed with intima-to-intima coaptation using the super microsurgery technique. The anastomosis was between the afferent lymphatic vessel and the recipient vein. The upper extremity lymphedema (UEL) index and indocyanine green (ICG) lymphography are utilized to evaluate the progression of lymphedema.

Inclusion Criteria:

• Breast cancer patients aged ≥ 18 years with an ECOG score > 1
• Breast cancer patients with post-axillary lymph node dissection diagnosed with stage 0 and I lymphedema.
• Those who have never undergone lymphedema physiotherapy.

Exclusion Criteria:

• Patients with dermal backflow before axillary lymph node dissection (ALND).
• Patients with breast cancer lymphedema who are unable to undergo a 24-month follow-up at Dharmais Cancer Hospital.
• Patients with iodine allergy, severe asthma, decreased kidney function, pregnancy, or breastfeeding.