Mouse Tail Models for Surgical Lymphedema Induction-A Comprehensive Systematic Review and Quality Assessment

Lymphedema remains a significant clinical and research challenge, requiring reliable experimental models to investigate its underlying mechanisms and evaluate potential therapies. Among available options, the surgical mouse tail model is widely used due to its simplicity, reproducibility, and low cost. While prior reviews have examined surgical lymphedema models across species, this is the first systematic review dedicated exclusively to the mouse tail model, providing a comprehensive evaluation of its application in practice and a formal assessment of its methodological reporting quality. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching four databases (PubMed, Embase, Web of Science, and Scopus) from inception to January 2025. Studies claiming to surgically induce lymphedema in the mouse tail were included. We defined lymphedema as a significant volume difference. Reporting quality was assessed using the Animals in Research Reporting In Vivo Experiments (ARRIVE 2.0) guidelines. The review was conducted and reported in accordance with the Synthesis Without Meta-analysis and Statistical Analyses and Methods in the Published Literature guidelines. One hundred five studies were included; 65% (68/105) successfully induced lymphedema. Four main models were identified. The median follow-up period was 35 days, and the median peak of swelling was 14 days. Adverse events such as tail ischemia were reported in 15 studies. Notably, 51% of studies (54/105) lacked controls. The mean reporting quality coefficient was 0.61, corresponding to "average" quality. The surgical mouse tail model is valuable for studying lymphatic pathophysiology but limited by inconsistent methods and reporting. Drawing on 105 studies and a formal multiframework quality assessment, this review identifies six key areas for improvement: (1) standardized induction protocols, (2) validated and consistently reported outcome measures, (3) control-group design, (4) defined minimum follow-up durations, (5) transparent adverse event reporting, and (6) mandatory adherence to ARRIVE 2.0 guidelines.