Abstract
Background Lymphedema is a progressive disease that negatively affects body image and physical,
psychological, and social functions. There is lack of evidence in the present literature
about the impact of super microsurgical lymphaticovenular anastomosis (LVA) on health-related
quality of life (HRQoL). The aim of this prospective study is to report the outcomes
of patients' HRQoL after LVA for lower and upper extremities lymphedema.
Methods Between September 2015 and February 2017, 74 patients with upper or lower limb lymphedema
(ULL or LLL) underwent LVA at our center. Quality of life (QoL) was assessed by lymphedema
QoL questionnaire (LyMQoL), which is a validated disease-specific instrument to measure
the impact of lymphedema on patient's lives, covering four domains: function, body
image, symptoms, and mood. All patients were evaluated preoperatively, 1 month after
surgery, and every 3 months up to 1 year. Additionally, we evaluated the episodes
of lymphangitis and the need for conservative therapy before and after surgery.
Results After a mean follow-up of 8.5 months (range: 2–21 months), we observed an increase
of 2.3 points in the overall QoL average for upper limb and 2.6 points for lower limb
(p < 0.001). A statistically significant improvement in all four domains (p < 0.01) was reported after surgery, being present from the first postoperative
months for both upper and lower extremities.
Conclusion Our study shows that lymphaticovenular anastomosis improves HRQoL in patients affected
by ULL and LLL. Additionally, both a reduction of episodes of lymphangitis and a decrease
in the need of conservative therapy were observed in this cohort of patients.
Keywords
lymphedema - quality of life - lymphaticovenular anastomosis