Abstract
Background Cancer-related lymphedema represents the first cause of noninfectious secondary extremity
lymphedema. This entity is a progressive and debilitating disease with no curative
treatment available. With the advent of lymphedema microsurgery, focus has turned
into risk reduction and prevention of the disease progression.
Methods Literature review was conducted to clarify current microsurgical approach to prophylaxis
of cancer treatment-related extremity lymphedema.
Results Prophylactic approach could be classified into primary and secondary prevention;
microsurgical procedures were performed simultaneously with cancer ablation in primary
prevention, and secondary prevention was performed secondarily after cancer treatment
for selected high-risk subclinical cases. Indocyanine green lymphography was the most
useful method for lymphedema screening after cancer treatment and to diagnose subclinical
lymphedema. Several lymphovenous shunt operations were performed as prophylactic procedures,
and classified into microsurgical lymphovenous implantation and supermicrosurgical
lymphovenous intima-to-intima coaptation. Both showed clinically significant prophylactic
effects.
Conclusion This review provides a comprehensive overview of the literature regarding microsurgical
interventions for the prevention of cancer-related extremity lymphedema. There are
several methods for lymphedema prophylaxis and further studies are required to clarify
indication of each method.
Keywords
lymphedema - breast cancer lymphedema - microsurgery - anastomosis - surgical - lymphovenous
anastomosis
