Afferent lymphovenous anastomosis for treating refractory high-output lymphocele following groin node dissection

Groin node dissection (GND) following uro-gynaecological cancer surgery has a very high incidence of lymphatic complications. These patients often suffer from prolonged wound healing due to high-output lymphatic discharge. Repeated debridement, sclerotherapy, embolisation are among the commonly used alternatives. These approaches tend to scar and obliterate the lymphatic system, leading to secondary lymphoedema.In recent years, there has been an exponential rise in the popularity and success of lymphovenous anastomosis as a prophylactic surgery following nodal dissection. It has been well-documented under the Lymphatic Microsurgical Preventive Healing Approach or as afferent lymphovenous anastomoses (LVAs), particularly after axillary lymph node dissection. Prophylactic LVAs in the lower limb following GND are not well explored, let alone managing immediate complications of lymphocele.With our case, we aim to demonstrate that the super-microsurgical procedure of multiple LVAs can be an excellent treatment option for managing high-output lymphatic complications, preventing long-term secondary lymphoedema and ensuring timely completion of adjuvant therapy.