Supermicrosurgical lymphoevenous anastomosis for the treatment of peripheral lymphedema: A systematic review of the literature

The effectiveness of supermicrosurgical lymphovenous anastomosis (LVA) for lymphedema treatment remains controversial. Currently, no evidence has been summarized. This study aimed to review the published literature on supermicrosurgical LVAs in the treatment of peripheral lymphedema and to analyze the surgical outcomes. Studies from databases (PubMed/MEDLINE, Cochrane Controlled Trial Data, and Embase) were collected to determine the effectiveness of supermicrosugrical LVAs for lymphedema. A systematic review was performed using individual patient data. Fifteen studies, including 578 patients (482 female, 72 male, and 24 unknown) with a mean age of 51 years, satisfied the needs of the study requirements. Supermicrosurgical LVAs for peripheral lymphedema have demonstrated substantial improvements in both objective and subjective findings in many patients. Moreover, in the long-term follow-up, the effectiveness of this treatment modality maintained a high efficacy of LVA in lymphedema cases. However, most studies provided low-quality evidence, and the conclusion is still not finalized.