{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:58:16Z","timestamp":1789073896273,"version":"build-2803163510"},"reference-count":79,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Lymphatic surgery has demonstrated promising outcomes for the treatment of lymphedema alongside nonsurgical techniques. Physiologic lymphatic surgeries including lymphovenous bypass and vascularized lymph node transplants address the fluid burden in lymphedema whereas reductive surgeries including suction lipectomy and excisional techniques address the fibroadipose component of the disease. Lymphedema patients often present with both fluid and fat components that may require different procedures for optimal results. In addition, the chronic, progressive nature of lymphedema can warrant the need for multiple procedures to address different anatomic areas as well as further improve outcomes. This paper reviews the current literature on staging different or repeated lymphatic procedures and proposes an algorithm to navigate physiologic and reductive lymphatic surgery when multiple procedures are needed to optimize surgical outcomes.<\/jats:p>","DOI":"10.1002\/jso.27984","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T06:14:49Z","timestamp":1731996889000},"page":"12-21","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Staging Approaches to Lymphatic Surgery: Techniques and Considerations"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0659-6242","authenticated-orcid":false,"given":"Ara A.","family":"Salibian","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery University of California, Davis School of Medicine Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery University of California, Davis School of Medicine Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketan M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Cedars Sinai Medical Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-14493-1_4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0049940"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-04418-y"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0126908"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01019.2013"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003690"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15238"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1642"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000210"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2020.11.022"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004529"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000003770"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199004000-00011"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007783"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.02.012"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30641"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2021.08.023"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1370"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(80)90276-7"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199809020-00021"},{"issue":"1","key":"e_1_2_8_22_1","first-page":"36","article-title":"Suction Assisted Protein Lipectomy (Sapl) Even for the Treatment of Chronic Fibrotic and Scarified Lower Extremity Lymphedema","volume":"49","author":"Lee M.","year":"2016","journal-title":"Lymphology"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000597"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005993"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1578814"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002683"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002674"},{"issue":"1","key":"e_1_2_8_28_1","first-page":"3","article-title":"The Diagnosis and Treatment of Peripheral Lymphedema: 2020 Consensus Document of the International Society of Lymphology","volume":"53","author":"Executive Committee of the International Society","year":"2020","journal-title":"Lymphology"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7252-4"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006520"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182268cd9"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31820cf5df"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2018.0014"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182a4d626"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1649518"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2020.08.010"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30689"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007507"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.10.007"},{"issue":"4","key":"e_1_2_8_40_1","first-page":"172","article-title":"Lymphovenous Anastomosis for the Treatment of Lymphedema: A Systematic Review of the Literature and Meta\u2010Analysis","volume":"53","author":"Nacchiero E.","year":"2020","journal-title":"Lymphology"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002086"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1381957"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000436840.69752.7e"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000201258.10304.16"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005591"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26783"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000472450.00980.04"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.01.021"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0035"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001912"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12051727"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000010612"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199612000-00022"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1080\/23320885.2020.1736943"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318180cd24"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002263"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002695"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24969"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1599100"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-015-1736-3"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000853"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1709275"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1065733"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12282"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.20517\/2347-9264.2022.77"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10143121"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198511000-00001"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.10.004"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2020.0098"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1080\/2000656X.2021.1964980"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1544182"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2014.06.005"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000009247"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22235"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030570"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25356"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008590"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030598"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs-23-247"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3515-y"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27984","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T10:36:18Z","timestamp":1747132578000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27984"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,18]]},"references-count":79,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/jso.27984"],"URL":"https:\/\/doi.org\/10.1002\/jso.27984","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,18]]},"assertion":[{"value":"2024-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}