{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:06:33Z","timestamp":1789085193324,"version":"build-2803163510"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Immediate lymphatic reconstruction (ILR) is a prophylactic approach for breast cancer\u2013related lymphedema (BCRL) following axillary lymph node dissection (ALND). This study assessed the preventive effect of ILR by evaluating data from prior studies, with a focus on time-course dynamics.<\/jats:p>\n                  <jats:p>A systematic review and meta-analysis was performed of 17 studies comparing ALND plus ILR with ALND alone. The primary outcome was BCRL incidence. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were stratified by follow-up duration (1\u201348 months).<\/jats:p>\n                  <jats:p>ILR significantly reduced BCRL incidence (RR: 0.37; 95% CI: 0.28\u20130.49). Time-stratified analysis indicated that the prophylactic effect was robust within the first 2 years postoperatively, peaking at 12 months (RR: 0.13; 95% CI: 0.04\u20130.46). Limited data beyond 2 years necessitates further studies to clarify long-term results.<\/jats:p>\n                  <jats:p>ILR reduces BCRL risk, remaining a valuable preventive strategy for breast cancer patients. This benefit remains unclear in the long term, highlighting the need for further high-quality trials with extended surveillance.<\/jats:p>","DOI":"10.1055\/a-2943-3724","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:53:24Z","timestamp":1787612004000},"source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Immediate Lymphatic Reconstruction after Breast Cancer Surgery: A Systematic Review and Time-course Dynamics Meta-analysis"],"prefix":"10.1055","author":[{"given":"Hong-Jie","family":"Chang","sequence":"first","affiliation":[{"name":"Taipei Medical University, Taiwan","place":["Taipei"],"department":["School of Medicine, College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Taipei Medical University, Taiwan","place":["Taipei"],"department":["School of Medicine, College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Yu","family":"Sun","sequence":"first","affiliation":[{"name":"National Taipei University of Technology, Taiwan","place":["Taipei"],"department":["Department of Computer Science and Information Engineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-6553","authenticated-orcid":false,"given":"Chiehfeng","family":"Chen","sequence":"first","affiliation":[{"name":"Taipei Medical University, Wan Fang Hospital, Taiwan","place":["Taipei"],"department":["Department of Surgery, Division of Plastic Surgery"]},{"name":"School of Medicine, College of Medicine, Taipei Medical University, Taiwan","place":["Taipei"],"department":["Department of Public Health"]},{"name":"Taipei Medical University, Taiwan","place":["Taipei"],"department":["Cochrane Taiwan"]},{"name":"Taipei Medical University, Taipei Municipal Wan Fang Hospital, Taiwan","place":["Taipei"],"department":["Evidence-Based Medicine Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Kuan","family":"Chiu","sequence":"additional","affiliation":[{"name":"Taipei Medical University, Wan Fang Hospital, Taiwan","place":["Taipei"],"department":["Department of Surgery, Division of Plastic Surgery"]},{"name":"School of Medicine, College of Medicine, Taipei Medical University, Taiwan","place":["Taipei"],"department":["Department of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanh Dinh","family":"Hoang","sequence":"additional","affiliation":[{"name":"Hai Phong University of Medicine and Pharmacy, Viet Nam","place":["Hai phong"],"department":["Department of Histopathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tun-Wen","family":"Pai","sequence":"additional","affiliation":[{"name":"National Taipei University of Technology, Taiwan","place":["Taipei"],"department":["Department of Computer Science and Information Engineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1245\/s10434-020-09104-2","article-title":"Immediate lymphatic reconstruction after axillary lymphadenectomy: a single-institution early experience","volume":"28","author":"J A Cook","year":"2021","journal-title":"Ann Surg Oncol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3390\/lymphatics3030015","article-title":"Surgical prevention of breast cancer-related lymphedema: a scoping review","volume":"3","author":"S Ahmed","year":"2025","journal-title":"Lymphatics"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.jaad.2017.03.022","article-title":"Lymphedema: pathophysiology and clinical manifestations","volume":"77","author":"A A Grada","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.breast.2017.09.006","article-title":"Incidence and risk factors of lymphedema after breast cancer treatment: 10 years of follow-up","volume":"36","author":"A CP Ribeiro Pereira","year":"2017","journal-title":"Breast"},{"issue":"05","key":"ref5","first-page":"CD003475","article-title":"Manual lymphatic drainage for lymphedema following breast cancer treatment","volume":"2015","author":"J Ezzo","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"379","DOI":"10.21037\/gs.2017.11.04","article-title":"Breast cancer-related lymphedema: risk factors, precautionary measures, and treatments","volume":"7","author":"T C Gillespie","year":"2018","journal-title":"Gland Surg"},{"issue":"01","key":"ref7","first-page":"18","article-title":"Risk factors of unilateral breast cancer-related lymphedema: an updated systematic review and meta-analysis of 84 cohort studies","volume":"31","author":"A Shen","year":"2022","journal-title":"Support Care Cancer"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s11764-012-0251-9","article-title":"Risk factors associated with breast cancer-related lymphedema in the WHEL study","volume":"7","author":"S A Dominick","year":"2013","journal-title":"J Cancer Surviv"},{"issue":"16","key":"ref9","doi-asserted-by":"crossref","first-page":"6535","DOI":"10.7314\/APJCP.2014.15.16.6535","article-title":"Systemic analysis on risk factors for breast cancer related lymphedema","volume":"15","author":"Y Q Zhu","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"e96748","DOI":"10.1371\/journal.pone.0096748","article-title":"Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review","volume":"9","author":"J T Hidding","year":"2014","journal-title":"PLoS One"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.21037\/gs-23-247","article-title":"Surgical treatment of breast cancer related lymphedema-the combined approach: a literature review","volume":"12","author":"D Drobot","year":"2023","journal-title":"Gland Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-023-06947-7","article-title":"Advances in the prevention and treatment of breast cancer-related lymphedema","volume":"200","author":"P MC Donahue","year":"2023","journal-title":"Breast Cancer Res Treat"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"138","DOI":"10.2340\/jphs.v60.43738","article-title":"The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study","volume":"60","author":"K J Kim","year":"2025","journal-title":"J Plast Surg Hand Surg"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1245\/s10434-008-0270-y","article-title":"Lymphedema microsurgical preventive healing approach: a new technique for primary prevention of arm lymphedema after mastectomy","volume":"16","author":"F Boccardo","year":"2009","journal-title":"Ann Surg Oncol"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1002\/jso.25177","article-title":"Immediate lymphatic reconstruction","volume":"118","author":"A R Johnson","year":"2018","journal-title":"J Surg Oncol"},{"issue":"09","key":"ref16","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1055\/s-0044-1785680","article-title":"Lymphovenous bypass for immediate lymphatic reconstruction in breast cancer patients undergoing axillary lymph node dissection: minimizing the risk of upper extremity lymphedema","volume":"40","author":"M C M\u00e9dor","year":"2024","journal-title":"J Reconstr Microsurg"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"e70109","DOI":"10.1002\/micr.70109","article-title":"Efficacy of immediate lymphatic reconstruction in prevention of breast cancer-related lymphedema: a systematic review and meta-analysis","volume":"45","author":"M X Li","year":"2025","journal-title":"Microsurgery"},{"issue":"71","key":"ref18","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"J AC Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"J A Sterne","year":"2016","journal-title":"BMJ"},{"issue":"7414","key":"ref21","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"J P Higgins","year":"2003","journal-title":"BMJ"},{"issue":"09","key":"ref22","doi-asserted-by":"crossref","first-page":"2500","DOI":"10.1245\/s10434-011-1624-4","article-title":"Surgical prevention of arm lymphedema after breast cancer treatment","volume":"18","author":"F M Boccardo","year":"2011","journal-title":"Ann Surg Oncol"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1245\/s10434-024-16640-8","article-title":"Preventing breast cancer-related lymphedema: a comprehensive analysis of a 9-year single-center experience of prophylactic lymphovenous bypass","volume":"32","author":"M J Cho","year":"2025","journal-title":"Ann Surg Oncol"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"334","DOI":"10.21037\/gs-22-554","article-title":"Assessing the preventive effect of immediate lymphatic reconstruction on the upper extremity lymphedema","volume":"12","author":"J H Chung","year":"2023","journal-title":"Gland Surg"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1097\/SLA.0000000000005952","article-title":"Efficacy of immediate lymphatic reconstruction to decrease incidence of breast cancer-related lymphedema: preliminary results of randomized controlled trial","volume":"278","author":"M Coriddi","year":"2023","journal-title":"Ann Surg"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1097\/AS9.0000000000000278","article-title":"Prophylactic lymphovenous bypass at the time of axillary lymph node dissection decreases rates of lymphedema","volume":"4","author":"R Deldar","year":"2023","journal-title":"Ann Surg Open"},{"issue":"10","key":"ref27","doi-asserted-by":"crossref","first-page":"3296","DOI":"10.1245\/s10434-015-4721-y","article-title":"Single institution experience with lymphatic microsurgical preventive healing approach (LYMPHA) for the primary prevention of lymphedema","volume":"22","author":"S Feldman","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.jss.2017.10.008","article-title":"A lymphedema surveillance program for breast cancer patients reveals the promise of surgical prevention","volume":"244","author":"M Hahamoff","year":"2019","journal-title":"J Surg Res"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1245\/s10434-023-14521-0","article-title":"Establishment and feasibility of an immediate lymphatic reconstruction program in a community health system","volume":"31","author":"P N Haravu","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"ref30","doi-asserted-by":"crossref","first-page":"5775","DOI":"10.1245\/s10434-021-10551-8","article-title":"Five-year breast surgeon experience in LYMPHA at time of ALND for treatment of clinical T1-4N1-3M0 breast cancer","volume":"28","author":"K M Herremans","year":"2021","journal-title":"Ann Surg Oncol"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1055\/a-2153-2203","article-title":"Immediate lymphatic reconstruction in 77 consecutive breast cancer patients: 2-year follow-up","volume":"40","author":"N K Le","year":"2024","journal-title":"J Reconstr Microsurg"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/PRS.0000000000009857","article-title":"Lymphatic microsurgical preventive healing approach for the primary prevention of lymphedema: a 4-year follow-up","volume":"151","author":"A S Levy","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/SLA.0000000000002827","article-title":"Evaluation of simplified lymphatic microsurgical preventing healing approach (S-LYMPHA) for the prevention of breast cancer-related clinical lymphedema after axillary lymph node dissection","volume":"270","author":"T Ozmen","year":"2019","journal-title":"Ann Surg"},{"issue":"18","key":"ref34","doi-asserted-by":"crossref","first-page":"2964","DOI":"10.3390\/cancers17182964","article-title":"Characterizing trends of lymphedema after axillary lymph node dissection with and without immediate lymphatic reconstruction","volume":"17","author":"K L Vangsness","year":"2025","journal-title":"Cancers (Basel)"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1055\/a-2336-0150","article-title":"Distally based lymphatic microsurgical preventive healing approach\u2014a modification of the classic approach","volume":"51","author":"A W Wong","year":"2024","journal-title":"Arch Plast Surg"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"104540","DOI":"10.1016\/j.breast.2025.104540","article-title":"Effectiveness of the lymphatic microsurgical preventive healing approach for avoiding breast cancer-related arm lymphedema","volume":"83","author":"S S Yono","year":"2025","journal-title":"Breast"},{"issue":"04","key":"ref37","doi-asserted-by":"crossref","first-page":"276","DOI":"10.12790\/ahm.21.0101","article-title":"Six-month follow-up for investigating the effect of prophylactic lymphovenous anastomosis on the prevention of breast cancer-related lymphedema: a preliminary study in a single institution","volume":"26","author":"J A Yoon","year":"2021","journal-title":"Arch Hand Microsurg"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jpra.2025.03.021","article-title":"Immediate lymphatic reconstruction for breast cancer-related lymphedema prevention: a systematic review","volume":"44","author":"S Z Aschen","year":"2025","journal-title":"JPRAS Open"},{"issue":"03","key":"ref39","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s10549-022-06758-2","article-title":"Oncologic safety of axillary lymph node dissection with immediate lymphatic reconstruction","volume":"196","author":"H M Guzzo","year":"2022","journal-title":"Breast Cancer Res Treat"},{"issue":"20","key":"ref40","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1056\/NEJMcp1803290","article-title":"Lymphedema after breast cancer treatment","volume":"379","author":"S G Rockson","year":"2018","journal-title":"N Engl J Med"},{"issue":"08","key":"ref41","first-page":"2207","article-title":"Transient swelling versus lymphoedema in the first year following surgery for breast cancer","volume":"21","author":"S L Kilbreath","year":"2013","journal-title":"Support Care Cancer"},{"issue":"02","key":"ref42","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1097\/PRS.0000000000002395","article-title":"Long-term patency of lymphovenous anastomoses: a systematic review","volume":"138","author":"S S Tourani","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"06","key":"ref43","doi-asserted-by":"crossref","first-page":"1015e","DOI":"10.1097\/PRS.0000000000010118","article-title":"Accessory lymphatic drainage pathways on indocyanine green lymphography in patients with breast cancer-related lymphedema","volume":"151","author":"L N Kim","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref44","doi-asserted-by":"crossref","first-page":"21103","DOI":"10.1038\/s41598-021-00396-2","article-title":"Indocyanine green lymphangiography is superior to clinical staging in breast cancer-related lymphedema","volume":"11","author":"M G J\u00f8rgensen","year":"2021","journal-title":"Sci Rep"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2943-3724.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:18:08Z","timestamp":1789082288000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2943-3724"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":44,"URL":"https:\/\/doi.org\/10.1055\/a-2943-3724","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8,24]]},"published":{"date-parts":[[2026,8,24]]}}}