Axillary lymphadenectomy for breast cancer - the influence of shoulder mobilisation on lymphatic drainage.
OBJECTIVE
The purpose of the present study was to study the influence of external axillary compression dressing with immobilisation of the ipsilateral shoulder after axillary lymph node dissection (ALND) on postoperative axillary drainage.


METHODS
One hundred consecutive women with breast cancer undergoing ALND were enrolled in this study. They were allowed free shoulder movement and were compared with a matched historical control group of 60 patients, in whom the ipsilateral arm was immobilised for four days. For all patients the amount of drainage was recorded each postoperative day until drain removal. Prognostic data on drainage amounts and duration were gathered from all patients. Complications were recorded.


RESULTS
Hospital stay was the only statistically significant difference between the two groups, it was prolonged for patients with immobilisation of the arm. The parameters found to influence the drain production with a statistically significant difference were body mass index and the removal of more than 10 lymph nodes. Postoperative complications were similar in both groups.


CONCLUSIONS
External compression dressing of the axillary cavity with immobilisation of the ipsilateral arm has no impact on the postoperative drainage volume and duration. It is associated with adverse effects, such as discomfort, prolonged hospital stay and shoulder stiffness.
Christodoulakis
M
M
Department of Surgical Oncology, University Hospital - Medical School University of Crete, Herakleion, Greece. cristod@med.uoc.gr
Sanidas
E
E
de Bree
E
E
Michalakis
J
J
Volakakis
E
E
Tsiftsis
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001458:Bandages; D001943:Breast Neoplasms / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009068:Movement; D012782:Shoulder; D013396:Suction; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome