title: [Diagnosis and treatment of breast cancer with central and medial localization using video-assisted thoracoscopic parasternal lymphadenectomy].
abstract: Since extended mastectomy after Urban involves an unjustifiably high level of trauma, this method has limited application. We have evolved a procedure of video-assisted thoracoscopic parasternal lymphadenectomy (VATPL). On completion of the experimental part using cadavers to work out the rationale for extent of surgery, clinical trials started. A total of 120 operations in patients aged 27-73 were performed (left-sided--64, right-sided--56), with the number of lymph nodes removed in each case ranging 1-10. Metastases were detected in 23 (19.2%), isolated lesions (metastases to parasternal lymph nodes alone)--6 (5.0%). With volume of removed tissue being identical, the findings on level of pain, amount of narcotic analgetics, hospital stay duration, intra- and postoperative complication incidence and cardiointervalography and pneumotachometry for VATPL patients were significantly better than for those treated by traditional (open-chest) procedure. It is concluded that VATPL is a highly effective and low-traumatizing diagnostic method. It may be recommended as an operation of choice for parasternal lymph collector involvement of central or medial localization.
authors.affiliation: Clinical Oncological Center, Ministry of Health of the Republic of Tatarstan, Kazan.
authors.forename: A Kh
authors.initials: AKh
authors.lastname: Istagilov
authors.forename: E I
authors.initials: EI
authors.lastname: Sigal
authors.forename: R G
authors.initials: RG
authors.lastname: Khamidullin
authors.forename: E V
authors.initials: EV
authors.lastname: Nagumanov
authors.forename: Kh M
authors.initials: KhM
authors.lastname: Gubaĭdullin
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D013249:Sternum; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods; D013908:Thoracotomy / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid