Clarification of Perioperative Nursing Support for Patients Undergoing Lymphaticovenular Anastomosis (LVA)

Purpose: Secondary lymphedema following cancer treatment is a chronic, progressive condition requiring lifelong self-care. For patients in whom conventional complex physical therapy (CPT) fails to produce sufficient improvement, lymphaticovenular anastomosis (LVA) has emerged as a promising surgical option. This study aims to clarify the specific perioperative care provided to patients undergoing LVA and to elucidate its role within the overall lymphedema self-care regimen. Methods and Participants: This qualitative, inductive study involved interviews with six nurses from medical institutions that perform LVA. Results: From the interview transcripts, 250 codes were extracted and classified into 11 categories. These categories represent the key aspects of perioperative nursing support for patients undergoing LVA. The perioperative support specific to LVA included the following: preparing for LVA indications and implementation preoperatively; confirming postoperative self-care, addressing deficiencies, and emphasizing the need for prompt follow-up in case of abnormalities; presenting LVA as a treatment to enable continued self-care; supporting a steady recovery process through multidisciplinary collaboration, acceptance of LVA, and physician instructions; and understanding and empathizing with the patient's feelings about LVA. Support related to continuing lymphedema self-care included the following: confirming whether self-care is tailored to the patient's individuality and supporting knowledge/skills in deficient areas; encouraging reflection on daily life and promoting skincare-centered prevention of cellulitis and early detection/management of infection signs; aligning goals and providing follow-up to tailor self-care support to each patient; reaffirming the importance of weight control for managing lymphedema symptoms; recognizing the necessity of rest to prevent symptom deterioration through daily life reflection; and providing financial assistance and words of encouragement to sustain self-care. Discussion: Given the mixed expectations and uncertainties that patients may have about LVA, psychologically sensitive support is essential during the perioperative period. Since LVA is a treatment aimed at rebuilding self-care, it is crucial that support is tailored to each patient’s individual life circumstances.