{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:13:03Z","timestamp":1771459983633,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"Abstract<\/jats:title>\n Lymphovenous anastomosis (LVA) is a microsurgical procedure that redirects stagnant lymph flow into the venous circulation, reducing fluid stasis in patients with secondary limb lymphedema. Although previous studies have reported that complex decongestive therapy redistributes fluid from the affected leg to other body segments, whether fluid reduction after LVA results from systemic elimination or intersegmental redistribution remains unclear. This study aimed to clarify the mechanism by analyzing the changes in segmental body water (SBW) volume using bioelectrical impedance analysis (BIA).<\/jats:p>\n We retrospectively analyzed the data of 40 Japanese women with unilateral stage II secondary leg lymphedema who underwent LVA from 2013 to 2021. Multifrequency segmental BIA was used to assess extracellular water, intracellular water, and SBW in the legs, trunk, and arms. Measurements were performed preoperatively and at least 12 months postoperatively. Changes in segmental and total body water (TBW) were statistically evaluated.<\/jats:p>\n Significant reductions were observed in SBW in the affected leg, and in the TBW (affected leg: 5.80\u20135.20 L, p\u2009<\u20090.001; TBW: 25.6\u201325.0\u2009L, p\u2009=\u20090.002), with no significant changes in the unaffected leg, trunk, or arms. Extracellular and intracellular water in the affected leg decreased significantly (p\u2009=\u20090.001 and p\u2009<\u20090.001, respectively), whereas the percentage of extracellular water remained stable.<\/jats:p>\n LVA achieved sustained reductions in segmental and TBW volumes, localized to the affected leg, without compensatory increases in other body segments. These findings support the efficacy of leg LVA in achieving long-term fluid homeostasis through systemic elimination of excess lymphatic fluid rather than redistribution.<\/jats:p>","DOI":"10.1055\/a-2803-4594","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T23:55:35Z","timestamp":1770422135000},"source":"Crossref","is-referenced-by-count":0,"title":["Systemic Elimination Rather than Redistribution: Segmental Body Water Analysis after Leg Lymphovenous Anastomosis"],"prefix":"10.1055","author":[{"given":"Yuto","family":"Kinjo","sequence":"additional","affiliation":[{"name":"Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Nagano, Japan"},{"name":"Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4858-6739","authenticated-orcid":false,"given":"Yoshichika","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoji","family":"Kondoh","sequence":"additional","affiliation":[{"name":"Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Nagano, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeko","family":"Kondoh","sequence":"additional","affiliation":[{"name":"Nursing Division, Ina Central Hospital, Ina, Nagano, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Umeda","sequence":"additional","affiliation":[{"name":"Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Nagano, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Yuzuriha","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"issue":"04","key":"ref1","first-page":"133","article-title":"The diagnosis and treatment of peripheral lymphedema: 2023 Consensus Document of the International Society of Lymphology","volume":"56","author":"Executive Committee of the International Society of Lymphology","year":"2023","journal-title":"Lymphology"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/SAP.0b013e318208fd75","article-title":"Lower extremity lymphedema index: a simple method for severity evaluation of lower extremity lymphedema","volume":"67","author":"T 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analysis","volume":"15","author":"M Toshima","year":"2022","journal-title":"Ann Vasc Dis"},{"issue":"09","key":"ref13","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1055\/a-2508-6778","article-title":"Clinical variables associated with lymphedema surgery: physiologic versus excisional","volume":"41","author":"J Lenders","year":"2025","journal-title":"J Reconstr Microsurg"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.jvsv.2023.07.010","article-title":"Changes in intracellular water volume after leg lymphedema onset and lymphaticovenular anastomosis as its surgical intervention","volume":"11","author":"Y Yasunaga","year":"2023","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"11","key":"ref15","doi-asserted-by":"crossref","first-page":"3678","DOI":"10.3390\/jcm9113678","article-title":"Fluid shifts induced by physical therapy in lower limb lymphedema patients","volume":"9","author":"B Brix","year":"2020","journal-title":"J Clin Med"},{"issue":"02","key":"ref16","first-page":"54","article-title":"Pathways of lymph and tissue fluid flow during intermittent pneumatic massage of lower limbs with obstructive lymphedema","volume":"44","author":"W L Olszewski","year":"2011","journal-title":"Lymphology"},{"issue":"08","key":"ref17","doi-asserted-by":"crossref","first-page":"e201700150","DOI":"10.1002\/jbio.201700150","article-title":"Indocyanine green near-infrared lymphangiography for evaluation of effectiveness of edema fluid flow under therapeutic compression","volume":"11","author":"M T Zaleska","year":"2018","journal-title":"J Biophotonics"}],"container-title":["Journal of Reconstructive 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