[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436029-105":59,"doc-detail-436029-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","primary-surgical-prevention-of-lymphedema","Primary surgical prevention of lymphedema","","Lymphedema in the upper and lower extremities can cause substantial morbidity, including restricted joint motion, pain, discomfort, intermittent cellulitis, and reduced quality of life. Physiological lymphatic reconstructions such as LVA, LVI, VLNT, and related microsurgical approaches improve outcomes but offer limited control or modest reversal. Because lymphedema is incurable, the review focuses on prevention, especially for iatrogenic cases including breast cancer–related lymphedema.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/primary-surgical-prevention-of-lymphedema/436029/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/primary-surgical-prevention-of-lymphedema/436029.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why does the review emphasize preventive measures for lymphedema?","Question",{"text":112,"@type":113},"Lymphedema is described as an incurable condition, so prevention is needed to reduce the likelihood of disease development, particularly in iatrogenic cases from cancer therapy.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What preventive categories are used to classify lymphedema prevention?",{"text":117,"@type":113},"Prevention is broadly classified into primary, secondary, and tertiary prevention, based on whether interventions aim to avoid disease entirely, detect it early, or mitigate illness after diagnosis.",{"name":119,"@type":110,"acceptedAnswer":120},"What is a key focus area in applying primary prevention?",{"text":121,"@type":113},"Understanding predictors of cancer-related (especially secondary) lymphedema helps clinicians stratify patients into risk groups and choose suitable interventions.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436029,1791047042,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","J Chin MedAssoc  \nReview ARticle  \nPrimary surgical prevention of lymphedema  \nJeremy Mingfa Suna,b, Takumi Yamamotob,*  \naPlastic Reconstructive and Aesthetic Surgery Service, Department of Surgery, Changi General Hospital, Singapore, Singapore; bDepartment of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan  \nAbstract  \nLymphedema in the upper and lower extremities can lead to significant morbidity in patients, resulting in restricted joint movements, pain, discomfort, and reduced quality of life. While physiological lymphatic reconstructions such as lymphovenous anastomosis (LVA), lymphovenous implantation (LVI), and vascularized lymph node transfer (VLNT) have shown promise in improving patients’conditions, they only provide limited disease progression control or modest reversal. As lymphedema remains an incurable condition, the focus has shifted toward preventive measures in developed countries where most cases are iatrogenic due to cancer treatments. Breast cancer–related lymphedema (BCRL) has been a particular concern, prompting the implementation of preventive measures like axillary reverse mapping. Similarly, techniques with lymph node-preserving concepts have been used to treat lower extremity lymphedema caused by gynecological cancers. Preventive lymphedema measures can be classified into primary, secondary, and tertiary prevention. In this comprehensive review, we will explore the principles and methodologies encompassing lymphatic microsurgical preventive healing approach (LYMPHA), LVA, lymphaticolymphatic anastomosis (LLA), VLNT, and lymphinterpositional-flap transfer (LIFT) . By evaluating the advantages and limitations of these techniques, we aim to equip surgeons with the necessary knowledge to effectively address patients at high risk of developing lymphedema.  \nKeywords: Immediate lymphatic reconstruction; Lymph vessel transfer; Lymphatic microsurgical preventing healing approach; Lymphedema prevention; Lymphovenous anastomosis  \n1. INTRODUCTION  \nUpper and lower extremity lymphedema can lead to significant morbidity in patients. They often complain of restricted joint movements, pain and discomfort, inability to don clothes and footwear, and intermittent attacks of cellulitis. Physiological lymphatic reconstructions such as lymphovenous anastomosis (LVA), lymphovenous implantations (LVI), and vascularized lymph node transfer (VLNT) have been gaining prominence in the past three decades. While these forms of lymphatic reconstruction have shown promise in improving patients’ conditions, they only provide limited disease progression control or modest reversal.  \nThe leading cause of secondary lymphedema worldwide is filariasis, caused by infection by Wuchereria bancrofti. This is vastly different in developed countries, as most cases are due to malignancy or related to surgical extirpation and adjuvant cancer therapy. As lymphedema in developed countries is mainly iatrogenic, the focus for clinicians has shifted to more preventive measures. Although the cumulative incidence of breast cancer–related lymphedema (BCRL) has been shown to be 13.5% at 2 years of follow-up, 30.5% at 5 years and 41.1% at 10  \n* Address correspondence. Dr. Takumi Yamamoto, Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail address:  \n[tyamamoto-tky@umin.ac.jp](tyamamoto-tky@umin.ac.jp) (T. Yamamoto).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2024) 87: 567-571.  \nReceived August 6, 2023; accepted March 22, 2024. doi: 10. 1097/JCMA.0000000000001101  \nCopyright © 2024, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses","cbCaijYDnlO0v0g2","https://ap.wps.com/l/cbCaijYDnlO0v0g2","pdf",302582,"English","# Introduction\n## Predictors of secondary lymphedema after cancer treatment","[{\"question\":\"Why does the review emphasize preventive measures for lymphedema?\",\"answer\":\"Lymphedema is described as an incurable condition, so prevention is needed to reduce the likelihood of disease development, particularly in iatrogenic cases from cancer therapy.\"},{\"question\":\"What preventive categories are used to classify lymphedema prevention?\",\"answer\":\"Prevention is broadly classified into primary, secondary, and tertiary prevention, based on whether interventions aim to avoid disease entirely, detect it early, or mitigate illness after diagnosis.\"},{\"question\":\"What is a key focus area in applying primary prevention?\",\"answer\":\"Understanding predictors of cancer-related (especially secondary) lymphedema helps clinicians stratify patients into risk groups and choose suitable interventions.\"}]","Primary surgical prevention of lymphedema | PDF",1790676486,13]