[Endoscopic axillary lymph node excision--results of a pilot study].
OBJECTIVE
Assessment of axillary nodal status with reduced shoulder-arm-morbidity remains a major challenge for primary surgery of breast cancer patients. In a pilot study endoscopic axillary lymph node dissection was evaluated.


METHODS
In 30 breast cancer patients axillary lymphadenectomy was performed after liposuction using an endoscopic approach. During a learning phase of 15 cases an open revision was routinely carried out. Later complete endoscopic lymph node dissection was performed. The exposition of anatomical landmarks, the number of resected lymph nodes, postoperative lymphorrhea, histopathological signs of traumatisation were assessed as well as intra and postoperative complications.


RESULTS
In any case we found excellent exposure of anatomical landmarks. Following a learning curve of 15 cases the average number of resected lymph nodes was equal to the average number of lymph nodes resected with conventional techniques (18.2 vs. 18.4, median 17 vs 18). Minimal intraoperative complications were observed. Postoperative lymphorrhea and seroma rate were not remarkably reduced in comparison with open procedures.


CONCLUSIONS
Our study demonstrates, that endoscopic lymph node dissection may be performed with a low complication rate and with identical accuracy as achieved by open techniques.
Kühn
T
T
Universitätsfrauenklinik Ulm. thorsten.kuehn@medizin.uni-ulm.de
Santjohanser
C
C
Koretz
K
K
Böhm
W
W
Kreienberg
R
R
D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D019723:Endoscopes; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000295:instrumentation*; D008198:Lymph Nodes / Q000473:pathology; D009367:Neoplasm Staging; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology; D012680:Sensitivity and Specificity