A prospective assessment of simple lymphatic drainage to prevent lower limb lymphedema in gynecological malignancies

Simple lymphatic drainage (SLD) is a self-administered technique for managing lymphedema; however, its efficacy in preventing lower limb lymphedema (LLE) following pelvic lymphadenectomy remains unclear. This prospective study evaluated the preventive effects of SLD at a single institution. A total of 224 patients were enrolled who underwent gynecological cancer surgery with pelvic lymphadenectomy between April 2011 and May 2012. After excluding patients with deep vein thrombosis, age ≥ 80 years, refusal to participate, and those with uncertain malignancy, 190 patients remained. A subset of 87 patients without adjuvant therapy was divided into two groups based on their preference: 24 in the SLD group and 63 in the control group. SLD group patients performed daily SLD for one year, and a 5-year follow-up was conducted. No significant differences were observed between groups in the change ratio of the lower limb circumference and the impedance method for the extracellular water: total body water ratio. The 5-year cumulative incidence of lymphedema (ISL stage I or more) was 37.5% in the SLD group and 23.5% in the control group, with no significant difference between the two groups. SLD does not contribute to the prevention of LLE following gynecological cancer surgery with pelvic lymphadenectomy.