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SYSTEMATIC REVIEW article

Front. Oncol.

Sec. Gynecological Oncology

This article is part of the Research TopicSurgical Advancements in Lymphedema: Innovations and ChallengesView all articles

Outcomes after liposuction-based treatment of lymphedema: a systematic review and meta-analysis

Provisionally accepted
Junzhe  ChenJunzhe ChenXiyao  FengXiyao FengYan  ZhouYan ZhouYun  WangYun WangShune  XiaoShune XiaoChengliang  DengChengliang Deng*
  • Affiliated Hospital of Zunyi Medical University, Zunyi, China

The final, formatted version of the article will be published soon.

Background: Lymphedema, a chronic condition involving lymphatic fluid accumulation, affects over 250 million people worldwide. Liposuction (LS), introduced in 1989, offers a minimally invasive option for non-pitting lymphedema by reducing fibrotic and hypertrophic tissues. However, LS requires ongoing compression therapy as it does not address the underlying lymphatic dysfunction. Although integrated approaches combining LS with lymphovenous anastomosis (LVA) or vascularized lymph node transfer (VLNT) aim to address both fluid removal and lymphatic repair, there remains a lack of consensus regarding the efficacy of these integrated liposuction-based treatments. Methods: A systematic review and meta-analysis conducted by the PRISMA and AMSTAR guidelines included studies from 1996 to 2024. Fifty-two studies (n=2,334) were reviewed and 23 (n=1,028) were analyzed quantitatively. Outcomes mainly included limb volume reduction, reliance on conservative treatment, improvement in infection rates, and improvement in the quality of life (QOL). Results: LS-based treatments significantly reduce volume in both upper and lower limbs (91.08% and 92.03%). Standalone LS reduced limb volume by 99.74% but relied on continuous compression therapy. Combined approaches achieved slightly lower reductions (87.31%), but significantly decreased compression dependence, improved lymphatic function, and enhanced QOL. Furthermore, LS-based interventions were associated with a potential reduction in infection episodes, thereby providing long-term benefits. Conclusion: Liposuction-based therapies effectively manage lymphedema by reducing limb volume and may reduce infections, while improving QOL. In addition, integrated approaches offer additional benefits by directly addressing lymphatic dysfunction and reducing reliance on compression therapy. Standardized methodologies and long-term studies are needed to refine the clinical guidelines and optimize outcomes.

Keywords: Lymphedema, Surgery, Integrated surgery, Liposuction, Meta-analysis

Received: 21 Jun 2025; Accepted: 07 Nov 2025.

Copyright: © 2025 Chen, Feng, Zhou, Wang, Xiao and Deng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Chengliang Deng, cheliadeng@sina.com

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