The Quality of Life after Lymphaticovenous Anastomosis in 118 Lower Limb Lymphedema Patients

Jin Geun Kwon; Yeongsong Kim; Min Young Jang; Hyunsuk Peter Suh; Changsik John Pak; Vaughan Keeley; Jae Yong Jeon; Joon Pio Hong

doi:10.1055/a-2117-4478

The Quality of Life after Lymphaticovenous Anastomosis in 118 Lower Limb Lymphedema Patients

Arch Plast Surg. 2023 Sep 8;50(5):514-522. doi: 10.1055/a-2117-4478. eCollection 2023 Sep.

Authors

Jin Geun Kwon¹, Yeongsong Kim¹, Min Young Jang¹, Hyunsuk Peter Suh¹, Changsik John Pak¹, Vaughan Keeley², Jae Yong Jeon³, Joon Pio Hong¹

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
² Lymphoedema Service, Royal Derby Hospital, Derby, United Kingdom.
³ Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Abstract

Background This is a prospective study on 118 patients who underwent lymphaticovenous anastomosis (LVA) due to secondary lower limb lymphedema between January 2018 and October 2020 to evaluate patients' quality of life (QOL) using the Quality of Life Measure for Limb Lymphedema (LYMQoL) questionnaire. Methods The outcome measurement included the LYMQoL leg scoring system tool evaluating the function, appearance, symptom, mood, and overall outcome. In addition, correlation analysis was performed for three factors: based on International Society of Lymphology (ISL) stages, disease duration, and amount of volume reduction. Results The LYMQoL tool overall satisfaction score significantly increased at all intervals from 4.4 ± 0.2 preoperative to 6.5 ± 0.3 postoperative at 12 months ( p < 0.001). Significant findings were seen for each domain scores compared preoperatively and at 12 months: function score (18.6 ± 0.5 to 15.4 ± 0.6), appearance score (17.8 ± 0.5 to 16.0 ± 0.6), symptom score (11.8 ± 0.3 to 8.9 ± 0.4), and mood score (14.5 ± 0.4 to 11.4 ± 0.5; p < 0.05). The correlation analysis between improvement of the overall score and the ISL stage ( p = 0.610, correlation coefficient [ r ] = - 0.047), disease duration ( p = 0.659, r = - 0.041), and amount of limb volume reduction ( p = 0.454, r = - 0.070) showed no statistical significance. Conclusion The QOL of secondary lower limb lymphedema patients was significantly improved after LVA regardless of the severity of disease, duration of disease, and amount of volume reduction after LVA. Understanding the patient-reported outcome measurement will help the surgeons to manage and guide the expectations of the patients.

Keywords: lymphedema; patient-reported outcome measures; quality of life.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).

Grants and funding

Funding This study was supported by a grant (2021IL0035) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea, and the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT; NRF-2019R1C1C1008451)