{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:25:17Z","timestamp":1774952717752,"version":"3.50.1"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003In lymphedema, lymphatic fluid accumulates in the interstitial space, and localized swelling appears. Lymphovenous anastomosis (LVA) is the most widely used surgery to rebuild a damaged lymphatic system; however, assessing outcome of LVA involves performing volume measurements, which provides limited information on body composition changes. Therefore, we analyzed the bioelectrical impedance analysis (BIA) parameters that can reflect the status of lymphedema patients who underwent LVA.<\/jats:p><jats:p>\n          Methods\u2003We retrospectively reviewed records of 42 patients with unilateral lower extremity lymphedema who had LVA. We measured the perioperative BIA parameters such as extracellular water (ECW) ratio and volume as defined by the percentage of excess volume (PEV). We evaluated the relationship between the amount of change in PEV and in BIA parameters before and after surgery. We confirmed the correlation between \u0394PEV and BIA parameters using Spearman's correlation.<\/jats:p><jats:p>\n          Results\u2003Most patients included had secondary lymphedema due to cancer. Average age was 51.76 years and average body mass index was 23.27. PEV and all BIA parameters after surgery showed a significant difference (p\u2009&lt;\u20090.01) compared with preoperative measurements. The ECW ratio aff\/unaff showed the strongest correlation with PEV with a correlation coefficient of 0.473 (p\u2009&lt;\u20090.01).<\/jats:p><jats:p>\n          Conclusion\u2003Our findings suggest that BIA parameters, especially ECW ratio aff\/unaff could reflect the status of patients with lower limb lymphedema after LVA. Appropriate use of BIA parameters may be useful in the postoperative surveillance of patients.<\/jats:p>","DOI":"10.1055\/s-0042-1750126","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T22:47:20Z","timestamp":1657579640000},"page":"171-178","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Utility of Bioelectrical Impedance Analysis Parameters for Evaluating Patients with Lower Limb Lymphedema after Lymphovenous Anastomosis"],"prefix":"10.1055","volume":"39","author":[{"given":"Woo Chul","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Geun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-9704","authenticated-orcid":false,"given":"Joon Pio","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Sik","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Ah","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Hwa","family":"Do","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hwayeong","family":"Cheon","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma Nessa","family":"Gelvosa","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Suk","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1534-7931","authenticated-orcid":false,"given":"Jae Yong","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1002\/jso.24158","article-title":"A comprehensive review of the natural lymphaticovenous communications and their role in lymphedema surgery","volume":"113","author":"M Miranda Garc\u00e9s","year":"2016","journal-title":"J Surg Oncol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.avsg.2017.03.197","article-title":"Lower extremity lymphedema management after gynecologic cancer surgery: a review of current management strategies","volume":"44","author":"Y Bakar","year":"2017","journal-title":"Ann Vasc Surg"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1055\/s-0038-1648220","article-title":"Cumulative experience in lymphovenous anastomosis for lymphedema treatment: the learning curve effect on the overall outcome","volume":"34","author":"N Pereira","year":"2018","journal-title":"J Reconstr Microsurg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1172\/JCI71608","article-title":"New developments in clinical aspects of lymphatic disease","volume":"124","author":"P S Mortimer","year":"2014","journal-title":"J Clin Invest"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1055\/s-0038-1636510","article-title":"Lymphovenous anastomosis bypass surgery","volume":"32","author":"E I Chang","year":"2018","journal-title":"Semin Plast Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1245\/s10434-014-3518-8","article-title":"Review of current surgical treatments for lymphedema","volume":"21","author":"J W Granzow","year":"2014","journal-title":"Ann Surg Oncol"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1002\/micr.30246","article-title":"Systematic review of lymphovenous anastomosis (LVA) for the treatment of lymphedema","volume":"37","author":"M F Scaglioni","year":"2017","journal-title":"Microsurgery"},{"key":"ref8","first-page":"504","article-title":"Lymphaticovenular anastomoses for lymphedema treatment: 18 months postoperative outcomes","volume":"2008","author":"C Auba","year":"2009","journal-title":"Microsurgery"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/PRS.0000000000002254","article-title":"Multisite lymphaticovenular bypass using supermicrosurgery technique for lymphedema management in lower lymphedema cases","volume":"138","author":"M Mihara","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/PSN.0000000000000306","article-title":"Bioimpedance spectroscopy for assessment of breast cancer-related lymphedema: a systematic review","volume":"40","author":"A J Forte","year":"2020","journal-title":"Plast Surg Nurs"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/ptj\/pzz175","article-title":"Assessing arm volume in people during and after treatment for breast cancer: reliability and convergent validity of the LymphaTech System","volume":"100","author":"J M Binkley","year":"2020","journal-title":"Phys Ther"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis\u2013part I: review of principles and methods","volume":"23","author":"U G Kyle","year":"2004","journal-title":"Clin Nutr"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/jso.24365","article-title":"A comprehensive review of bioimpedance spectroscopy as a diagnostic tool for the detection and measurement of breast cancer-related lymphedema","volume":"114","author":"C Seward","year":"2016","journal-title":"J Surg Oncol"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/IGC.0b013e31820866e1","article-title":"Assessment of bilateral limb lymphedema by bioelectrical impedance spectroscopy","volume":"21","author":"L Ward","year":"2011","journal-title":"Int J Gynecol Cancer"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1089\/lrb.2018.0028","article-title":"Correlation of L-Dex bioimpedance spectroscopy with limb volume and lymphatic function in lymphedema","volume":"17","author":"C J Coroneos","year":"2019","journal-title":"Lymphat Res Biol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3389\/fonc.2020.00111","article-title":"Feasibility of bioimpedance analysis to assess the outcome of complex decongestive therapy in cancer treatment-related lymphedema","volume":"10","author":"K H Cho","year":"2020","journal-title":"Front Oncol"},{"issue":"00","key":"ref17","first-page":"1","article-title":"Indocyanine green lymphography and lymphoscintigraphy severity stage showed strong correlation in lower limb lymphedema","volume":"00","author":"J A Yoon","year":"2020","journal-title":"Lymphat Res Biol"},{"issue":"01","key":"ref18","first-page":"3","article-title":"The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology","volume":"53","author":"I Congress","year":"2020","journal-title":"Lymphology"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1038\/ejcn.2013.9","article-title":"Accuracy of segmental multi-frequency bioelectrical impedance analysis for assessing whole-body and appendicular fat mass and lean soft tissue mass in frail women aged 75 years and older","volume":"67","author":"M Kim","year":"2013","journal-title":"Eur J Clin Nutr"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.bjps.2019.06.041","article-title":"Multi-segment bioimpedance can assess patients with bilateral lymphedema","volume":"73","author":"E S Qin","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1055\/s-0038-1675368","article-title":"Bioelectrical impedance analysis of water reduction in lower-limb lymphedema by lymphaticovenular anastomosis","volume":"35","author":"Y Yasunaga","year":"2019","journal-title":"J Reconstr Microsurg"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1055\/s-0040-1713670","article-title":"Water reductive effect of lymphaticovenular anastomosis on upper-limb lymphedema: bioelectrical impedance analysis and comparison with lower-limb lymphedema","volume":"36","author":"Y Yasunaga","year":"2020","journal-title":"J Reconstruct Microsurg"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1055\/s-0037-1599100","article-title":"Systematic review of the surgical treatment of extremity lymphedema","volume":"33","author":"H M Carl","year":"2017","journal-title":"J Reconstr Microsurg"},{"issue":"44","key":"ref24","doi-asserted-by":"crossref","first-page":"e12945","DOI":"10.1097\/MD.0000000000012945","article-title":"Reference values of bioelectrical impedance analysis for detecting breast cancer-related lymphedema","volume":"97","author":"M Jung","year":"2018","journal-title":"Medicine (Baltimore)"},{"issue":"05","key":"ref25","doi-asserted-by":"crossref","first-page":"687","DOI":"10.5535\/arm.2011.35.5.687","article-title":"Prediction of treatment outcome with bioimpedance measurements in breast cancer related lymphedema patients","volume":"35","author":"L Kim","year":"2011","journal-title":"Ann Rehabil Med"},{"issue":"06","key":"ref26","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1089\/lrb.2017.0082","article-title":"Normative interlimb impedance ratios: implications for early diagnosis of uni- and bilateral, upper and lower limb lymphedema","volume":"16","author":"M L Steele","year":"2018","journal-title":"Lymphat Res Biol"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.apmr.2010.11.017","article-title":"Comparison of diagnostic accuracy of clinical measures of breast cancer-related lymphedema: area under the curve","volume":"92","author":"B J Smoot","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1159\/000499607","article-title":"Limitations of fat-free mass for the assessment of muscle mass in obesity","volume":"12","author":"B Jensen","year":"2019","journal-title":"Obes Facts"},{"issue":"08","key":"ref29","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.3109\/02841860903061683","article-title":"Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up","volume":"48","author":"A Sagen","year":"2009","journal-title":"Acta Oncol"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.ygyno.2017.06.004","article-title":"Lymphedema following gynecological cancer: Results from a prospective, longitudinal cohort study on prevalence, incidence and risk factors","volume":"146","author":"S C Hayes","year":"2017","journal-title":"Gynecol Oncol"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S1072-7515(02)01230-9","article-title":"Preservation of muscle fascia to decrease lymphedema after complete axillary and ilioinguinofemoral lymphadenectomy for melanoma","volume":"195","author":"G Lawton","year":"2002","journal-title":"J Am Coll Surg"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.3390\/cancers14041076","article-title":"Lymphatic function of the lower limb after groin dissection for vulvar cancer and reconstruction with lymphatic SCIP flap","volume":"14","author":"A A Caretto","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"A J Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"issue":"03","key":"ref34","first-page":"238","article-title":"The role of radionuclide lymphoscintigraphy in chyluria","volume":"13","author":"Z Yuan","year":"2010","journal-title":"Hell J Nucl Med"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1007\/s00259-019-04576-1","article-title":"The feasibility of quantitative parameters of lymphoscintigraphy without significant dermal backflow for the evaluation of lymphedema in post-operative patients with breast cancer","volume":"47","author":"K Kim","year":"2020","journal-title":"Eur J Nucl Med Mol Imaging"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1750126.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:18:21Z","timestamp":1677111501000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1750126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,11]]},"references-count":35,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,2,22]]},"published-print":{"date-parts":[[2023,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1750126","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,11]]}}}