title: Complete endoscopic axillary lymph node dissection without liposuction for breast cancer: initial experience and mid-term outcome.
abstract: OBJECTIVE
  To present our initial experience with complete endoscopic axillary lymph node dissection (EALND) in 4 breast cancer patients with respect to feasibility, safety, and clinical outcome.
  
  
  METHODS
  Between January 2003 and March 2004, 4 women consented to be treated with lumpectomy followed by complete (level I, II, and III) EALND without liposuction, at the Laparoendoscopic Unit of Athens Medical School. All 4 patients presented with a solitary breast cancer lesion smaller than 2 cm in diameter and a negative clinical and sonographic lymph node status (<1 cm).
  
  
  RESULTS
  All the operations were completed endoscopically in less than 70 minutes (44 to 69 min). The axillary lymph node harvest ranged between 12 and 21 nodes. No lymphedema, motor nerve damage, seroma formation, or wound complications were observed. Prolonged hospitalization, owing to persistent lymphorrhoea was required for 1 patient. During a mean follow-up of 21.3 months, 2 patients reported mild hypoesthesia-paresthesia along the upper medial part of the respective arm, whereas no tumor recurrences were documented.
  
  
  CONCLUSIONS
  Although partial EALND has not been established as the treatment of choice for axillary management, complete EALND seems to be a feasible and effective minimally invasive treatment modality, which could be safely applied in patients with positive sentinel node biopsy, treated in specialized centers.
authors.affiliation: Laparoendoscopic Unit, 1st Department of Propaedeutic Surgery, Hippocration Hospital of Athens, Athens Medical School, 114 Q. Sofia Avenue, 11527 Athens, Greece.
authors.forename: Ilias P
authors.initials: IP
authors.lastname: Gomatos
authors.forename: George
authors.initials: G
authors.lastname: Filippakis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Albanopoulos
authors.forename: George
authors.initials: G
authors.lastname: Zografos
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Leandros
authors.forename: John
authors.initials: J
authors.lastname: Bramis
authors.forename: Manousos M
authors.initials: MM
authors.lastname: Konstadoulakis
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery*; D004724:Endoscopy; D005240:Feasibility Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome