@article{01J4REY6XVTB6SVH39FFD6328H,
  abstract     = {{Introduction Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life. The first choice of treatment is a conservative treatment, consisting of exercises, skin care, lymph drainage and compression. Reconstructive lymphatic surgery is also often performed, that is, lymphovenous anastomoses, lymph node transfer or a combination. However, robust evidence on the effectiveness of reconstructive lymphatic surgery is missing. Therefore, the objective of this trial is to investigate the added value of reconstructive lymphatic surgery to the conservative treatment in patients with lymphoedema.

Methods and analysis A multicentre randomised controlled and pragmatic trial was started in March 2022 in three Belgian university hospitals. 90 patients with arm lymphoedema and 90patients with leg lymphoedema will be included. All patients are randomised between conservative treatment alone (control group) or conservative treatment with reconstructive lymphatic surgery (intervention group). Assessments are performed at baseline and at 1, 3, 6, 12, 18, 24 and 36months. The primary outcome is lymphoedema-specific quality of life at 18months. Key secondary outcomes are limb volume and duration of wearing the compression garment at 18months. The approach of reconstructive lymphatic surgery is based on presurgical investigations including clinical examination, lymphofluoroscopy, lymphoscintigraphy, lymph MRI or CT angiography (if needed). All patients receive conservative treatment during 36months, which is applied by the patient's own physical therapist and by the patient self. From months 7 to 12, the hours a day of wearing the compression garment are gradually decreased.

Ethics and dissemination The study has been approved by the ethical committees of University Hospitals Leuven, Ghent University Hospital and CHU UCL Namur. Results will be disseminated via peer-reviewed journals and presentations.}},
  articleno    = {{e078114}},
  author       = {{Devoogdt, Nele and De Vrieze, Tessa and Heroes, An-Kathleen and Bechter-Hugl, Beate and Fieuws, Steffen and Godderis, Lode and Segers, Katarina and Maleux, Geert and Deltombe, Thierry and Frippiat, Jacqueline and Servaes, Maxime and Berners, Aline and Fosseprez, Philippe and Krug, Bruno and Kayser, Francoise and Falticeanu, Ana and Randon, Caren and Monten, Christel and Van Landuyt, Koenraad and De Pypere, Bernard and Degraeve, Liesl and Decorte, Tina and De Schryver, Mieke and Van Besien, Vickie and Devos, Daniel and Suominen, Sinikka and Ayala, Jaume Masia and Pons, Gemma and Fourneau, Inge and Thomis, Sarah}},
  issn         = {{2044-6055}},
  journal      = {{BMJ OPEN}},
  keywords     = {{Vascular medicine,Plastic & reconstructive surgery,VASCULAR SURGERY,HEALTH QUESTIONNAIRE,LIMB LYMPHEDEMA,DISABILITY,REPRODUCIBILITY,RELIABILITY,VALIDITY}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{12}},
  title        = {{SurLym trial : study protocol for a multicentre pragmatic randomised controlled trial on the added value of reconstructive lymphatic surgery to decongestive lymphatic therapy for the treatment of lymphoedema}},
  url          = {{http://doi.org/10.1136/bmjopen-2023-078114}},
  volume       = {{14}},
  year         = {{2024}},
}

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