{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:40:03Z","timestamp":1789494003052,"version":"build-2803163510"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Despite major advancements in lymphatic care, there remains a lack of consensus across institutions regarding the evaluation and surgical management of lymphedema. The aim of this study is to describe the practices for diagnosis and surgical treatment of lymphedema across accredited Lymphatic Education &amp; Research Network (LE&amp;RN) comprehensive Centers of Excellence (COEs).<\/jats:p>\n                  <jats:p>A survey was distributed to directors of the 16 LE&amp;RN comprehensive COEs in January 2023. Directors were queried on lymphatic surgeon training, evaluation of potential surgical patients, description of surgical operations offered at their center, surgical algorithms, and operative techniques for various procedures.<\/jats:p>\n                  <jats:p>Nine COEs completed the survey (56% response rate). Eight of nine centers reported having an interdisciplinary surgical evaluation program, including lymphatic surgery (100%, 8\/8), certified lymphedema therapy (100%, 8\/8), and lymphatic medicine (75%, 6\/8). COEs use a variety of lymphatic imaging modalities, with indocyanine green lymphography (89%, 8\/9) and lymphoscintigraphy (78%, 7\/9) being the most common. While all COEs offered debulking procedures, 67% (6\/9) offered physiologic procedures (lymphovenous bypass and vascularized lymph node transplant), and 56% (5\/9) offered immediate lymphatic reconstruction. There was no consensus on surgical algorithms or operative approaches.<\/jats:p>\n                  <jats:p>LE&amp;RN comprehensive COEs consistently use multidisciplinary care teams for medical and surgical evaluations, but there is significant variability in lymphatic imaging modalities used and lymphatic surgery types and techniques. These findings underscore the need for continued research and standardization of lymphatic surgery outcomes to develop consensus.<\/jats:p>","DOI":"10.1055\/a-2540-0648","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T18:50:56Z","timestamp":1741373456000},"page":"001-006","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Treatment of Lymphedema at LE&amp;RN Comprehensive Centers of Excellence"],"prefix":"10.1055","volume":"42","author":[{"given":"James E.","family":"Fanning","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosie","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Shillue","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Services, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Fleishman","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Repicci","sequence":"additional","affiliation":[{"name":"Lymphatic Education and Research Network, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Donohoe","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruv","family":"Singhal","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.09.018","article-title":"Are racial disparities in stroke care still prevalent in certified stroke centers?","volume":"22","author":"P Bhattacharya","year":"2013","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1245\/s10434-018-07108-7","article-title":"Impact of breast center accreditation on compliance with breast quality performance measures at commission on cancer-accredited centers","volume":"26","author":"M E Miller","year":"2019","journal-title":"Ann Surg Oncol"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/asj\/sjw138","article-title":"Is office-based surgery safe? 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