Fragmentation of axillary fibrofatty tissue during dissection facilitates preservation of the intercostobrachial nerve and the lateral thoracic vein.
The preservation of neurovascular elements passing through the axillary fibrofatty tissue (the intercostobrachial nerve and the lateral thoracic vein) could be techniqually demanding if an en bloc axillary dissection is performed in the conventional way. In this paper we describe a surgical technique for more successful preservation of these elements, by which fragmentation of the axillary fibrofatty tissue is planned and performed "in advance". The techniques of axillary sampling biopsies, where lymphatic vessels are always divided, have shown that cutting of the lymph routes does not increase the risk of local regional recurrence. After adopting and applying this technique in a series of 22 consecutive dissections, the nerve was spared in 22 patients (100%) (compared to an earlier series where the nerve was spared in 53 of 65 patients (81.5%)), while the vein was spared in 21 patients (95%) (earlier 22 of 65 patients (34%)).
Ivanovic
N
N
Department of Surgical Oncology, University Medical Center Bezanijska Kosa, Autoput bb, 11000 Belgrade, Serbia. ivannv@eunet.yu
Granic
M
M
Randjelovic
T
T
Todorovic
S
S
D000328:Adult; D000368:Aged; D001365:Axilla / Q000098:blood supply* / Q000294:innervation*; D001917:Brachial Plexus / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D013909:Thorax / Q000098:blood supply; D014680:Veins / Q000601:surgery