{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:08:52Z","timestamp":1791954532568,"version":"4.3.4"},"reference-count":39,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019353","name":"Belgian Health Care Knowledge Centre","doi-asserted-by":"publisher","award":["KCE19-1245"],"award-info":[{"award-number":["KCE19-1245"]}],"id":[{"id":"10.13039\/501100019353","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,6]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"\n Introduction<\/jats:title>\n Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb\/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life. The first choice of treatment is a conservative treatment, consisting of exercises, skin care, lymph drainage and compression. Reconstructive lymphatic surgery is also often performed, that is, lymphovenous anastomoses, lymph node transfer or a combination. However, robust evidence on the effectiveness of reconstructive lymphatic surgery is missing. Therefore, the objective of this trial is to investigate the added value of reconstructive lymphatic surgery to the conservative treatment in patients with lymphoedema.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n A multicentre randomised controlled and pragmatic trial was started in March 2022 in three Belgian university hospitals. 90 patients with arm lymphoedema and 90\u2009patients with leg lymphoedema will be included. All patients are randomised between conservative treatment alone (control group) or conservative treatment with reconstructive lymphatic surgery (intervention group). Assessments are performed at baseline and at 1, 3, 6, 12, 18, 24 and 36\u2009months. The primary outcome is lymphoedema-specific quality of life at 18\u2009months. Key secondary outcomes are limb volume and duration of wearing the compression garment at 18\u2009months. The approach of reconstructive lymphatic surgery is based on presurgical investigations including clinical examination, lymphofluoroscopy, lymphoscintigraphy, lymph MRI or CT angiography (if needed). All patients receive conservative treatment during 36\u2009months, which is applied by the patient\u2019s own physical therapist and by the patient self. From months 7 to 12, the hours a day of wearing the compression garment are gradually decreased.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n The study has been approved by the ethical committees of University Hospitals Leuven, Ghent University Hospital and CHU UCL Namur. Results will be disseminated via peer-reviewed journals and presentations.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT05064176<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078114","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T14:20:19Z","timestamp":1715350819000},"page":"e078114","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["SurLym trial: study protocol for a multicentre pragmatic randomised controlled trial on the added value of reconstructive lymphatic surgery to decongestive lymphatic therapy for the treatment of lymphoedema"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05064176","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05064176","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8117-7080","authenticated-orcid":false,"given":"Nele","family":"Devoogdt","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven \u2013 University of Leuven, Leuven, Belgium"},{"name":"Department of Vascular Surgery, Centre for Lymphedema, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"De Vrieze","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven \u2013 University of Leuven, Leuven, 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