{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:28:26Z","timestamp":1792121306166,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Lymphoedema is a chronic, debilitating condition caused by an affected lymphatic system. Supermicrosurgical techniques like lymphovenous anastomosis (LVA) have gained popularity because of its minimal invasiveness, better aesthetic outcome, and lower costs in comparison to physical medicine. This systematic review aims to evaluate the clinical effectiveness and safety of LVA in comparison to conservative or other surgical treatments for primary or secondary lymphoedema patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A systematic literature search was performed in four databases in December 2017. We applied a methodological framework based on the HTA Core Model\u00ae. According to the grading of recommendations, assessment, development, and evaluation (GRADE) scheme, we synthesized the data on each selected outcome category. The studies were systematically assessed for risk of bias (RoB) using the Risk of Bias Assessment tool for Non\u2010randomized controlled studies (RoBANS) and the Institute of Health Economics (IHE) Risk of Bias checklist for case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 629 citations were identified and five studies were assessed eligible for final inclusion (one non\u2010randomized controlled trial and four prospective single\u2010arm studies). Across the studies, 217 patients were enrolled. All studies showed a moderate to high RoB. The strength of evidence for the effectiveness and safety of LVA is \u201cvery low.\u201d Due to the methodological shortcomings of the available evidence, no conclusions can be made about the effectiveness of the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LVA might be a safe technique for patients with primary and secondary lymphoedema\u2014particularly because no serious complications were reported. Furthermore, LVA may have a role in the prevention of lymphoedema.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30514","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T06:26:25Z","timestamp":1569911185000},"page":"763-772","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Efficacy and safety assessment of lymphovenous anastomosis in patients with primary and secondary lymphoedema: A systematic review of prospective evidence"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0255-9874","authenticated-orcid":false,"given":"Katharina","family":"Rosian","sequence":"first","affiliation":[{"name":"Ludwig Boltzmann Institute for Health Technology Assessment  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0313-0997","authenticated-orcid":false,"given":"Michal","family":"Stanak","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Health Technology Assessment  Vienna Austria"},{"name":"Faculty of Philosophy and Education University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"issue":"5","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1097\/SAP.0000000000000513","article-title":"Comparison of vascularized supraclavicular lymph node transfer and lymphaticovenular anastomosis for advanced stage lower extremity lymphedema","volume":"74","author":"Akita S.","year":"2015","journal-title":"Annals of Plastic Surgery"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24170"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1370356"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5282-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1599100"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181e5f6a9"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182a4d626"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4180-1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-008-9932-5"},{"key":"e_1_2_7_11_1","volume-title":"Joint action 2 work package 8. HTA Core model\u00ae version 3.0","author":"EUnetHTA","year":"2016"},{"issue":"4","key":"e_1_2_7_12_1","first-page":"170","article-title":"The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology","volume":"49","author":"Executive Committee","year":"2016","journal-title":"Lymphology"},{"key":"e_1_2_7_13_1","unstructured":"Gesellschaft Deutschsprachiger Lymphologen (GDL).S2k Leitlinie \u2010 Diagnostik und Therapie der Lymph\u00f6deme. 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