{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:48:16Z","timestamp":1777769296743,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,4,16]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Groin node dissection (GND) following uro-gynaecological cancer surgery has a very high incidence of lymphatic complications. These patients often suffer from prolonged wound healing due to high-output lymphatic discharge. Repeated debridement, sclerotherapy, embolisation are among the commonly used alternatives. These approaches tend to scar and obliterate the lymphatic system, leading to secondary lymphoedema.<\/jats:p>\n                  <jats:p>In recent years, there has been an exponential rise in the popularity and success of lymphovenous anastomosis as a prophylactic surgery following nodal dissection. It has been well-documented under the Lymphatic Microsurgical Preventive Healing Approach or as afferent lymphovenous anastomoses (LVAs), particularly after axillary lymph node dissection. Prophylactic LVAs in the lower limb following GND are not well explored, let alone managing immediate complications of lymphocele.<\/jats:p>\n                  <jats:p>With our case, we aim to demonstrate that the super-microsurgical procedure of multiple LVAs can be an excellent treatment option for managing high-output lymphatic complications, preventing long-term secondary lymphoedema and ensuring timely completion of adjuvant therapy.<\/jats:p>","DOI":"10.1136\/bcr-2025-269139","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:15:23Z","timestamp":1777479323000},"page":"e269139","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Afferent lymphovenous anastomosis for treating refractory high-output lymphocele following groin node dissection"],"prefix":"10.1136","volume":"19","author":[{"given":"Bharat","family":"Saxena","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery, Nanavati Max Super Speciality Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameya","family":"Bindu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemant","family":"Tongaonkar","sequence":"additional","affiliation":[{"name":"Surgical Oncology, Nanavati Max Super Speciality Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6718-0849","authenticated-orcid":false,"given":"Pareeksit Rajkumar","family":"Bagchi","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"2026042909150977000_19.4.e269139.1","doi-asserted-by":"crossref","DOI":"10.1177\/17588359221127254","article-title":"An update on treatment of penile cancer","volume":"14","author":"Chadha","year":"2022","journal-title":"Ther Adv Med Oncol"},{"key":"2026042909150977000_19.4.e269139.2","doi-asserted-by":"crossref","first-page":"3210","DOI":"10.21037\/tau.2019.08.37","article-title":"Inguinal lymph node dissection for penile cancer: a contemporary review","volume":"9","author":"Teh","year":"2020","journal-title":"Transl Androl Urol"},{"key":"2026042909150977000_19.4.e269139.3","doi-asserted-by":"crossref","first-page":"2764","DOI":"10.1245\/s10434-010-1026-z","article-title":"Prospective assessment of postoperative complications and associated costs following inguinal lymph node dissection (ILND) in melanoma patients","volume":"17","author":"Chang","year":"2010","journal-title":"Ann Surg Oncol"},{"key":"2026042909150977000_19.4.e269139.4","first-page":"306","article-title":"Incidence, risk factors, and management of lymphocele following lymphadenectomy","volume":"42","author":"Radovanovic","year":"2017","journal-title":"Ann Vasc Surg"},{"key":"2026042909150977000_19.4.e269139.5","first-page":"734","article-title":"Complications and management of inguinal lymph node dissection in penile cancer patients","volume":"38","author":"Carl","year":"2020","journal-title":"Urol Oncol"},{"key":"2026042909150977000_19.4.e269139.6","first-page":"93","article-title":"Postoperative lymphatic complications: Current perspectives on treatment","volume":"265","author":"Pereira","year":"2021","journal-title":"J Surg Res"},{"key":"2026042909150977000_19.4.e269139.7","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1002\/jso.25166","article-title":"Lymphovenous anastomosis for the treatment of lymphedema","volume":"118","author":"Chang","year":"2018","journal-title":"J Surg Oncol"},{"key":"2026042909150977000_19.4.e269139.8","first-page":"1001","article-title":"Lymphaticovenous anastomosis for lymphocele treatment: An alternative to conventional therapies","volume":"134","author":"Mihara","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"2026042909150977000_19.4.e269139.9","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s00423-020-01927-7","article-title":"Definition and severity grading of postoperative lymphatic leakage following inguinal lymph node dissection","volume":"405","author":"Gerken","year":"2020","journal-title":"Langenbecks Arch Surg"},{"key":"2026042909150977000_19.4.e269139.10","first-page":"76","article-title":"Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema","volume":"106","author":"Koshima","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"2026042909150977000_19.4.e269139.11","first-page":"763e","article-title":"Lymphedema surgery: Current concepts and future directions","volume":"147","author":"Chang","year":"2021","journal-title":"Plast Reconstr Surg"},{"key":"2026042909150977000_19.4.e269139.12","first-page":"625","article-title":"Supermicrosurgical lymphaticovenous anastomosis for the prevention and treatment of secondary lymphedema: A systematic review","volume":"11","author":"Giudice","year":"2022","journal-title":"J Clin Med"},{"key":"2026042909150977000_19.4.e269139.13","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000004529","article-title":"Outcomes of Lymphovenous Anastomosis for Lower Extremity Lymphedema: A Systematic Review","volume":"10","author":"Verhey","year":"2022","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026042909150977000_19.4.e269139.14","doi-asserted-by":"crossref","first-page":"S234","DOI":"10.1097\/SAP.0000000000001864","article-title":"Lymphedema Incidence After Axillary Lymph Node Dissection: Quantifying the Impact of Radiation and the Lymphatic Microsurgical Preventive Healing Approach","volume":"82","author":"Johnson","year":"2019","journal-title":"Ann Plast Surg"},{"key":"2026042909150977000_19.4.e269139.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.jvsv.2024.101863","article-title":"Supermicrosurgery lymphaticovenous and lymphaticolymphatic anastomosis: Technical detail and short-term follow-up for immediate lymphatic reconstruction in breast cancer treatment-related lymphedema prevention","volume":"12","author":"Brahma","year":"2024","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"2026042909150977000_19.4.e269139.16","doi-asserted-by":"crossref","first-page":"665e","DOI":"10.1097\/PRS.0000000000001715","article-title":"The Superior-Edge-of-the-Knee Incision Method in Lymphaticovenular Anastomosis for Lower Extremity Lymphedema","volume":"136","author":"Seki","year":"2015","journal-title":"Plast Reconstr Surg (1946)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:15:26Z","timestamp":1777479326000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":16,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,29]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bcr-2025-269139"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269139","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}