Interventional procedure overview of lymphovenous anastomosis during axillary or inguinal node dissection for preventing secondary lymphoedema
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Methods
NICE identified studies and reviews relevant to LVA during ALND or ILND for preventing secondary LE from the medical literature. The following databases were searched between the date they started to 20 February 2023: MEDLINE, PREMEDLINE, EMBASE, Cochrane Library and other databases. Trial registries and the internet were also searched (see the literature search strategy). Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.
The following inclusion criteria were applied to the abstracts identified by the literature search:
Publication type: clinical studies were included with emphasis on identifying good quality studies. Abstracts were excluded if they did not report clinical outcomes. Reviews, editorials, and laboratory or animal studies, were also excluded and so were conference abstracts, because of the difficulty of appraising study methodology, unless they reported specific adverse events that are not available in the published literature.
Patients with cancer conditions needing ALND or ILND.
Intervention or test: (preventative) LVA.
Outcome: articles were retrieved if the abstract contained information relevant to the safety, efficacy, or both.
If selection criteria could not be determined from the abstracts the full paper was retrieved.
Potentially relevant studies not included in the main evidence summary are listed in the section on other relevant studies.
Find out more about how NICE selects the evidence for the committee.
Databases | Date searched | Version/files |
|---|---|---|
MEDLINE (Ovid) | 21/02/2023 | 1946 to February 20, 2023 |
MEDLINE In-Process (Ovid) | 21/02/2023 | 1946 to February 20, 2023 |
MEDLINE Epubs ahead of print (Ovid) | 21/02/2023 | 1946 to February 20, 2023 |
EMBASE (Ovid) | 22/02/2023 | 1974 to 2023 February 22 |
EMBASE Conference (Ovid) | 22/02/2023 | 1974 to 2023 February 22 |
Cochrane Database of Systematic Reviews – CDSR (Cochrane Library) | 21/02/2023 | Issue 2 of 12, February 2023 |
Cochrane Central Database of Controlled Trials – CENTRAL (Cochrane Library) | 21/02/2023 | Issue 2 of 12, February 2023 |
International HTA database (INAHTA) | 22/02/2023 | - |
The following search strategy was used to identify papers in MEDLINE. A similar strategy was used to identify papers in other databases.
1 Anastomosis, Surgical/ 34,790
2 Anastomos*.tw. 73,401
3 1 or 2 86,709
4 Lymphedema/su [Surgery] 1,648
5 Lymphed*.tw. 8,138
6 4 or 5 8,670
7 3 and 6 715
8 (MLVA or LVA or LYMPHA).tw. 2,457
9 ((Lymphaticoven* or Lymphoven* or Lymphatic-ven*) adj4 anastomos*).tw. 625
10 Lymph Node Excision/ 37,512
11 (Lymp* node adj4 (excision* or dissect* or ablat* or cut* or remove*)).tw. 21,147
12 ((Axill* or Inguin*) adj4 lymph node adj4 (excision* or dissect* or ablat* or cut* or remove*)).tw. 3,960
13 (ALND or INLD).tw. 1,419
14 Lymphangitis/su [Surgery] 19
15 Lymphangit*.tw. 1,376
16 lymphatic microsurgical preventive healing approach.tw. 9
17 Lymphedema/pc 578
18 or/7-17 52,118
19 *Breast Neoplasms/ 279,369
20 *Penile neoplasm/ 5,089
21 *Vulvar neoplasm/ 7,389
22 *skin neoplasm/ 118,043
23 *Melanoma/ 79,301
24 or/19-23 450,891
25 Lymphedema/ 10,411
26 24 and 25 2,104
27 Breast Cancer Lymphedema/ 384
28 BCRL.tw. 373
29 ((Breast* or penile* or vulva* or skin* or melanom*) adj4 (neoplasm* or cancer* or carcino* or adenocarcino* or tumour* or tumor* or malignan* or lump* or metast*) adj4 lymphed*).tw. 1,135
30 or/26-29 2,579
31 18 and 30 1,000
32 animals/ not Humans/ 5,060,889
33 31 not 32 995
34 limit 33 to english language 893
35 limit 34 to ed=20150101-20230228 449
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