Contrast-enhanced ultrasound planning linked to more successful, faster venturi-like LVA in retrospective cohort of 29 women

The abstract of a retrospective cohort study reports that preoperative contrast-enhanced ultrasound lymphography (CEUS-L) was associated with more successful anastomoses and shorter median anastomosis times during venturi-like lymphaticovenous anastomosis (LVA) for lower-extremity lymphedema following gynecologic cancer treatment. The study included 29 women treated between November 2021 and August 2023, divided into 21 who underwent CEUS-L before surgery and eight who did not.

The primary comparison concerned surgical indicators. The CEUS-L group had a median of eight successful anastomoses per patient, compared with three in the control group, a difference reported as P < 0.001. Median anastomosis time was 55 minutes in the CEUS-L group versus 97.5 minutes in the control group, also reported as P < 0.001. The investigators calculated the true-positive rate of CEUS-L using successful anastomoses relative to preoperative marking-guided surgical incisions. They reported 156 successful cases among 173 such incisions, corresponding to a true-positive rate of 90.2%. These findings indicate an association between preoperative CEUS-L and the measured localization and operative efficiency indicators in this cohort.

The abstract also reports that the detection rate of dermal backflow differed across clinical stages of lymphedema. It was 0% in stage I, 62.5% in stage II and 90.9% in stage III. The difference between stages I and III reached statistical significance after Bonferroni adjustment, with P < 0.05. This staging pattern was an additional imaging observation reported by the study; the abstract does not establish how dermal-backflow detection affected postoperative outcomes.

The findings remain bounded by the study design and population. It was a small retrospective cohort consisting exclusively of women with lower-extremity lymphedema after gynecologic cancer treatment, and it compared outcomes according to whether preoperative CEUS-L had been implemented. The reported endpoints focused on successful anastomoses, anastomosis time and the true-positive rate of CEUS-L. The abstract does not provide long-term follow-up or establish that the imaging approach improves patient-reported symptoms, limb volume, quality of life or other clinical benefits. Its conclusion states that larger prospective studies with long-term follow-up are required.

Subject of Research: Preoperative ultrasound planning for venturi-like lymphaticovenous anastomosis in women with secondary lower-extremity lymphedema

Article Title: Preoperative planning of venturi-like lymphaticovenous anastomosis for secondary lower extremity lymphedema using contrast-enhanced ultrasound

Article References: Wei, M., Lu, K.-F., Li, Y.-F., Liu, H., Du, P., Liu, Y., Hu, Q.-H., He, H.-F., Hou, C.-J., Sun, L.-T., & Tang, J.-L. (2026). Preoperative planning of venturi-like lymphaticovenous anastomosis for secondary lower extremity lymphedema using contrast-enhanced ultrasound. BMC Cancer. https://doi.org/10.1186/s12885-026-16707-7

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16707-7

Keywords: lymphedema, lymphaticovenous anastomosis, contrast-enhanced ultrasound, lymphography, gynecologic cancer, surgical planning, retrospective cohort, dermal backflow, Preoperative, planning, venturi-like, lymphaticovenous