Endoscopic axillary surgery in breast cancer.
BACKGROUND
The aim was to provide an assessment of the current status of endoscopic axillary surgery in patients with breast cancer.


METHODS
Fifty-three patients underwent endoscopic lymphadenectomy. The surgical efficiency (operating time, number of resected nodes, intraoperative and postoperative complications), short-term morbidity (duration of drainage, total lymph flow, seroma rate) and long-term outcome (pain, numbness, mobility, strength, oedema) were assessed. The incidence and severity of different arm symptoms were compared with the results of 396 patients treated with a conventional axillary procedure. Finally, all available data relating to endoscopic axillary surgery were reviewed.


RESULTS
The operating time ranged from 60 to 150 min. A mean 17 (range 10-28) lymph nodes was resected. The extent of postoperative lymphorrhoea (mean 372 ml) and the seroma rate (eight of 34 patients) were not significantly reduced in comparison with conventional surgery. The assessment of long-term morbidity revealed fewer disturbances of sensitivity and a decreased rate of severe symptom intensity for pain, oedema and complaints related to mobility.


CONCLUSIONS
Despite excellent visualization of anatomical landmarks and improved long-term morbidity, endoscopic lymph node dissection cannot be regarded as a suitable technique for routine axillary management in breast cancer because of long operating times.
Kuehn
T
T
Departments of Gynaecology and Obstetrics and Pathology, University of Ulm, Germany. kuehn.thorsten@t-online.de
Santjohanser
C
C
Grab
D
D
Klauss
W
W
Koretz
K
K
Kreienberg
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery*; D004322:Drainage; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology