Objective To summarize the research progress of rodent models of secondary lymphedema (SL) and provide a reference for selecting appropriate animal models in SL research. Methods Recent literature on rodent SL models at home and abroad was comprehensively analyzed, summarizing model categories, development techniques, strengths, and weaknesses. Results Current research primarily utilizes rats and mice to establish SL models. The main model types include hind limb, forelimb, tail, and head/neck models. The hind limb model is the most frequently employed, typically requiring surgery combined with irradiation to induce stable chronic edema. Forelimb models primarily simulate upper limb lymphedema, but exhibit relatively rapid edema resolution. Tail models offer operational simplicity and are predominantly used for studying acute edema mechanisms and interventions; however, they demonstrate poor clinical relevance. Emerging head/neck models provide a valuable tool for investigating head and neck cancer-associated lymphedema. These models exhibit variations in lymphedema duration, degree of fibrosis, and edema incidences. Conclusion Existing models still fall short in faithfully replicating the chronicity, fibrosis, fat deposition, and complex microenvironment characteristic of human chronic lymphedema. Future research must integrate multidisciplinary approaches, optimize model construction strategies, and explore novel modeling approaches to more accurately mimic the human disease and advance SL prevention and treatment research.
ObjectiveTo summarize the research progress on the clinical application of lymphaticovenous anastomosis (LVA). MethodsA comprehensive review of previous literature on LVA was conducted, summarizing the anastomosis sites, techniques, number of anastomoses, and clinical applications, with particular emphasis on the evolution and development of LVA anastomosis sites and techniques. Results LVA is a bypass drainage surgery that has undergone multiple stages of development since its inception. Due to individual differences, the location, method, number of anastomoses, and clinical applications are often based on the surgeon’s experience, and there is still no unified application scenario. ConclusionLVA is a highly promising surgical procedure that can effectively relieve symptoms of early- and mid-stage lymphedema. With the advantages of minimal invasiveness and rapid recovery, it can serve as a first-line surgical option for lymphedema.
Objective To evaluate the effectiveness of lymphaticovenular anastomosis (LVA) combined with perioperative targeted multi-layer circular lymphatic drainage in the treatment of secondary lower limb lymphedema using a prospective randomized controlled trial. Methods In a prospective randomized controlled trial, 80 patients with secondary lower limb lymphedema admitted between January 2023 and September 2025 were initially enrolled and allocated to either the trial group (LVA+targeted lymphatic drainage) or the control group (LVA+conventional lymphatic drainage), 40 in each group. After 2 dropouts in the control group, 78 patients (40 in the trial group, 38 in the control group) were included for analysis. There was no significant difference in the baseline data (P>0.05), such as age, gender, disease duration, and preoperative lower limb circumference difference, functional scores, and levels of vascular endothelial growth factor C (VEGF-C), transforming growth factor β1 (TGF-β1), and interleukin 6 (IL-6). Both groups underwent LVA. The trial group received perioperative targeted multi-layer circular lymphatic drainage, while the control group received conventional manual lymphatic drainage. Changes in lower limb circumference difference, functional scores, and levels of VEGF-C, TGF-β1, and IL-6 were compared between the two groups at various time points before and after operation. Overall effectiveness and safety were also assessed. Results All patients were followed up 3-12 months (mean, 6.5 months). Postoperatively, the trial group demonstrated significantly better functional recovery and a superior trend in lower limb circumference reduction at all time points compared to the control group (P<0.05). Serological analysis indicated a more pronounced increase in VEGF-C level in the trial group (P<0.05), and a downward trend in TGF-β1 and IL-6 levels in both groups (P<0.05); no significant difference was observed in TGF-β1 and IL-6 levels between groups (P>0.05). At 3 months after operation, indocyanine green fluorescence (ICG) lymphography showed an anastomosis patency rate of 95.0% (38/40) in the trial group, significantly higher than the 68.4% (26/38) in the control group (P<0.05). The overall effectiveness was rated as significantly effective in 30 cases and effective in 15 cases in the trial group, while as significantly effective in 15 cases, effective in 15 cases, and ineffective in 8 cases in the control group. The difference between groups was significant (P<0.05). The incidence of complications showed no significant difference between trial group and control group (2.5% vs 7.9%, P>0.05). ConclusionThe application of targeted multi-layer circular lymphatic drainage during the perioperative period of LVA is safe and effective. It significantly promotes lower limb circumference reduction and functional recovery without increasing the risk of complications.
Objective To review the research progress of lymphaticovenous anastomosis (LVA) in the treatment of severe extremity trauma and prospect its clinical application prospects. Methods Based on the existing literature, this study elaborated on the pathological mechanism and adverse effects of post-traumatic lymphatic drainage disorder, systematically sorted out the clinical research cases and therapeutic effects of LVA in the treatment of severe extremity trauma, and analyzed the limitations of the current clinical application of LVA. Results Severe extremity trauma can cause extensive disruption of superficial and deep lymphatic vessels, which exacerbates post-traumatic limb swelling in the early stage and easily progresses to chronic lymphedema in the long term, thus hindering the process of wound repair and reducing patients’ quality of life. Existing small-sample clinical studies and cases have confirmed that LVA can effectively reconstruct the lymphatic drainage pathway and exert a definite therapeutic effect on post-traumatic lymphedema. However, this technique is still in the early stage of clinical application, with unsolved problems including no consensus on the optimal application timing, incompletely elucidated underlying mechanism of action, and relatively high technical threshold. Conclusion LVA exhibits important clinical application potential in the treatment of severe extremity trauma, and can serve as an effective method for clinically controlling limb swelling caused by post-traumatic lymphatic stasis. In the future, research should focus on the early therapeutic application of LVA for extremity trauma, clarify its optimal intervention timing and indications, optimize the treatment regimen by combining with traditional detumescence measures, so as to further enhance its clinical value in the treatment of severe extremity trauma.
