title: Lymphatico-venous anastomosis as treatment for breast cancer-related lymphedema: a prospective study on quality of life.
abstract: OBJECTIVE
  Lymphedema is a chronic and disabling sequel of breast cancer treatment that can be treated by lymphatico-venous anastomosis (LVA). Artificial connections between the venous and lymphatic system are performed supermicrosurgically. This prospective study analyses the effect of LVA on quality of life.
  
  
  METHODS
  A prospective study was performed between November 2015 and July 2016 on consecutive patients in the Maastricht University Medical Centre. Quality of life was considered as the primary outcome, and the Lymphedema International Classification of Functioning (Lymph-ICF) questionnaire was used. Discontinuation of compressive stockings and arm volume, using the Upper Extremity Lymphedema index (UEL-index), were the secondary outcomes.
  
  
  RESULTS
  Twenty women with early-stage breast cancer-related lymphedema (BCRL) were included. The mean age was 55.9 ± 4 years and the median BMI was 25.1 [21-30] kg/m2. The mean follow-up was 7.8 ± 1.5 months. Statistically significant improvement in quality of life was achieved in the total score and for all the quality of life domains after one year of follow-up (p < 0.05). The discontinuation rate in compressive stockings use was 85%. The difference in mean relative volume did not show a statistically significant decrease.
  
  
  CONCLUSIONS
  LVA for early-stage BCRL resulted in a significant improvement in quality of life and a high rate in stocking discontinuation.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Anouk J M
authors.initials: AJM
authors.lastname: Cornelissen
authors.affiliation: Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Melissa
authors.initials: M
authors.lastname: Kool
authors.affiliation: Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Tiara R
authors.initials: TR
authors.lastname: Lopez Penha
authors.affiliation: Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Xavier H A
authors.initials: XHA
authors.lastname: Keuter
authors.affiliation: Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Andrzej A
authors.initials: AA
authors.lastname: Piatkowski
authors.affiliation: Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Heuts
authors.affiliation: Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: René R W J
authors.initials: RRWJ
authors.lastname: van der Hulst
authors.affiliation: Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. shanshan.qiushao@mumc.nl.
authors.forename: Shan Shan
authors.initials: SS
authors.lastname: Qiu
mesh_terms: D000714:Anastomosis, Surgical; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D042601:Lymphatic Vessels / Q000601:surgery; D008209:Lymphedema / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D014680:Veins / Q000601:surgery
keywords: Breast cancer; Lymphatico-venous anastomosis; Lymphedema; Quality of life