{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T12:37:31Z","timestamp":1792240651638,"version":"4.4.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Breast cancer treatment, including axillary lymph node excision, radiation, and chemotherapy, can cause upper extremity lymphedema, increasing morbidity and health care costs. Institutions increasingly perform prophylactic lymphovenous bypass (LVB) at the time of axillary lymph node dissection (ALND) to reduce the risk of lymphedema but reports of complications are lacking. We examine records from the American College of Surgeons (ACS) National Surgery Quality Improvement Program (NSQIP) database to examine the safety of these procedures.<\/jats:p><jats:p>\n          Methods\u2003Procedures involving ALND from 2013 to 2019 were extracted from the NSQIP database. Patients who simultaneously underwent procedures with the Current Procedural Terminology (CPT) codes 38999 (other procedures of the lymphatic system), 35201 (repair of blood vessel), or 38308 (lymphangiotomy) formed the prophylactic LVB group. Patients in the LVB and non-LVB groups were compared for differences in demographics and 30-day postoperative complications including unplanned reoperation, deep vein thrombosis (DVT), wound dehiscence, and surgical site infection. Subgroup analysis was performed, controlling for extent of breast surgery and reconstruction. Multivariate logistic regression was performed to identify predictors of reoperation.<\/jats:p><jats:p>\n          Results\u2003The ALND without LVB group contained 45,057 patients, and the ALND with LVB group contained 255 (0.6%). Overall, the LVB group was associated with increased operative time (288 vs. 147\u2009minutes, p\u2009&lt;\u20090.001) and length of stay (1.7 vs. 1.3 days, p\u2009&lt;\u20090.001). In patients with concurrent mastectomy without immediate reconstruction, the LVB group had a higher rate of DVTs (3.0 vs. 0.2%, p\u2009=\u20090.009). Reoperation, wound infection, and dehiscence rates did not differ across subgroups. Multivariate logistic regression showed that LVB was not a predictor of reoperations.<\/jats:p><jats:p>\n          Conclusion\u2003Prophylactic LVB at time of ALND is a generally safe and well-tolerated procedure and is not associated with increased reoperations or wound complications. Although only four patients in the LVB group had DVTs, this was a significantly higher rate than in the non-LVB group and warrants further investigation.<\/jats:p>","DOI":"10.1055\/s-0042-1742730","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:02:37Z","timestamp":1644883357000},"page":"613-620","source":"Crossref","is-referenced-by-count":17,"title":["National Outcomes of Prophylactic Lymphovenous Bypass during Axillary Lymph Node Dissection"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0965-7100","authenticated-orcid":false,"given":"Sarah N.","family":"Chiang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary B.","family":"Skolnick","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Westman","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin M.","family":"Sacks","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joani M.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"issue":"32","key":"ref1","doi-asserted-by":"crossref","first-page":"5213","DOI":"10.1200\/JCO.2008.16.3725","article-title":"Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements","volume":"26","author":"S A McLaughlin","year":"2008","journal-title":"J Clin Oncol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1089\/lrb.2011.0007","article-title":"Prevalence and prognostic significance of secondary lymphedema following breast cancer","volume":"9","author":"S Hayes","year":"2011","journal-title":"Lymphat Res Biol"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1200\/JCO.2008.18.3517","article-title":"Incidence, treatment costs, and complications of lymphedema after breast cancer 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Microsurg"},{"issue":"01","key":"ref38","first-page":"71","article-title":"LyMPHA and the prevention of lymphatic injuries: a rationale for early microsurgical intervention","volume":"30","author":"C C Campisi","year":"2014","journal-title":"J Reconstr Microsurg"}],"container-title":["Journal of Reconstructive 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