{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:47:53Z","timestamp":1792025273526,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"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":["Microsurgery"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Lymphedema is always initially treated by combined decongestive physiotherapy (CDP). Those cases, refractory to CDP, may be managed by surgical therapy. One of the most used microsurgical procedures is represented by the technique of lymphatic\u2010venous anastomosis (LVA). But very few papers report long term results of LVA. The aim of this study is to assess the long\u2010term patency of multiple lymphatic\u2010venous anastomosis (MLVA) for the treatment of secondary lymphedemas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2014 to December 2014, 101 patients (mean age: 56.94\u2009\u00b1\u20098.98\u2009years; female\/male: 86\/15) affected by secondary cancer\u2010related lymphedema (38 lower and 63 upper limbs) were treated by MLVA. All lymphedemas had previously been treated by conservative therapy without sustained results. Many patients (78%) had 1\u20133 episodes of acute lymphangitis\/year. Lymphoscintigraphy, venous duplex\u2010ultrasonography, and abdominal or axillary ultrasound investigation were performed preoperatively. MLVA patency was assessed by the lymphatic transport index (LyTI) and lymphoscintigraphic pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 1\u00a0year after surgery, excess volume reduction was 75%\u201390% in the early stage II secondary lymphedemas, and 60%\u201375% in the late stage II. The decrease in volume maintained stability in the 5\u2010years follow\u2010up period. Two more advanced lower and one upper limb lymphedemas had 45%\u201360% reduction. LyTI showed a significant decrease between the preoperative mean value (31.7\u00a0\u00b1\u20099.43) and after 18\u2009months from surgery (11.2\u00a0\u00b1\u20091.91) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001). MLVA patency was shown in 98 (97%) patients. No patients had evidence of postoperative lymphangitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrated the long\u2010term patency of MLVA in the treatment of cancer\u2010related lymphedemas.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30944","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T10:13:04Z","timestamp":1659435184000},"page":"668-676","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Long\u2010term patency of multiple lymphatic\u2010venous anastomoses in cancer\u2010related lymphedema: A single center observational study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5369-6852","authenticated-orcid":false,"given":"Francesco","family":"Boccardo","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostics (DISC) University of Genoa  Genoa Italy"},{"name":"Department of Cardio\u2010Thoracic\u2010Vascular and Endovascular Surgery San Martino Polyclinic Hospital  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregorio","family":"Santori","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostics (DISC) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Villa","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Radiotherapy \u2013 Nuclear Medicine San Martino Polyclinic Hospital  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Accogli","sequence":"additional","affiliation":[{"name":"Department of Neuro\u2010Science\u2014Rehabilitation Unit San Martino Polyclinic Hospital  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Dessalvi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostics (DISC) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20735"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22254"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-1624-4"},{"key":"e_1_2_7_5_1","first-page":"20","article-title":"Surgical prevention and treatment of lymphedema after lymph node dissection in patients with cutaneous melanoma","volume":"46","author":"Boccardo F.","year":"2013","journal-title":"Lymphology"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22129"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31824f20d4"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5282-4"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(93)90331-F"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-2752(1998)18:8<462::AID-MICR7>3.0.CO;2-C"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7252-4"},{"key":"e_1_2_7_12_1","first-page":"42","article-title":"A single\u2010site technique of multiple lymphatic\u2010venous anastomoses for the treatment of peripheral lymphedema: Long\u2010term clinical outcome","volume":"32","author":"Campisi C. 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