Longitudinal Evaluation of Lower Limb Volume Changes Following Lymphaticovenular Anastomosis

Background: Lymphaticovenular anastomosis (LVA) surgery alleviates lymphedema by redirecting congested lymphatic fluid. This study retrospectively evaluated gradual changes in lower limb volume post-LVA surgery using a Perometer. We retrospectively analyzed cases of LVA surgeries performed at our hospital. Methods: Lower limb volumes of lymphedema patients were measured at 1 week, and 1, 3, and 6 months postoperatively. At 6 months postoperatively, patients with at least 5% improvement from preoperative levels and those with a slight worsening were classified into improvement and exacerbation groups, respectively; group background factors were compared. Results: Forty-two limbs were included as follows: improvement group, 11 limbs; exacerbation group, 13 limbs. The improvement group showed a regression from postoperative week (POW) 1 to postoperative month (POM) 3 but improved again by POM6. The exacerbation group tended to worsen from POM1 onward. There were strong correlations between limb volumes at 1 and 6 months (r = 0.79, p < 0.001), and at 3 and 6 months (r = 0.81, p < 0.001). A comparison of background factors between improvement and exacerbation groups showed significant differences in BMI changes (p < 0.001). Conclusions: Limb volume at POM1 was correlated with that at POM6 volume. The improvement group showed continued volume reduction beyond 1 month, whereas the exacerbation group showed little further reduction. These descriptive findings may be informative for anticipating the postoperative course.