Chylous Fistula Following Axillary Lymphadenectomy

Flores, Erene V.; Castro, Gonzalo de; Casal, E.; Sobrino, Constantino

doi:10.1016/j.cireng.2012.09.003

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…The mean±SD for drain removal was 11.22±0.80 days with range (10-12) days in study group and 14.41±1.40 with range (12)(13)(14)(15)(16)(17) days in control group (P <0.001). Also, there was significant reduction in incidence of seroma favoring the study group by incidence 6.5% (2 patients out of 31) compared to 25% (9 patients out of 36) in control group (P = 0.040), these rates are compatible with previously mentioned ranges by Anand R and Boostrom SY.…”

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confidence: 88%

Role of axillary reverse mapping in decreasing complications after axillary dissection in breast cancer

et al. 2017

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INTRODUCTIONBreast cancer is the most common malignancy in women worldwide and its incidence increases every year.1 From the total female cancer cases in Egypt, breast cancer represented 35.1%. 2The primary site of lymphatic drainage of the breast is the axillary lymph nodes that involved in regional metastatic disease in breast cancer. Axillary lymph node dissection is the standard treatment of axillary lymph node metastasis. It is important for local control, staging and increase the possibility of survival benefit. 3Most of the serious complications after breast surgery are attributed to axillary lymph node dissection such as; lymphedema, seroma and major neurovascular injuries. 4 Seroma is the most common problem occurring after axillary lymph node dissection; excessive fluid accumulation usually stretches the skin and causes it to sag, resulting in patient discomfort, and delay of adjuvant ABSTRACT Background: Breast cancer is one of the most leading causes of cancer deaths in female. Surgical treatment is considered the corner stone in its management. Axillary lymph node dissection (ALND) is an integral step in most of surgeries done, however it has many morbidities like prolonged seroma and lymphedema. Axillary reverse mapping (ARM) procedure was first described in 2007 in a trial to map the axillary lymphatics of the arm and avoid its injury therefore lymph complications. Methods: A prospective, randomized, controlled study over 72 female patients who underwent modified radical mastectomy (MRM). Patients were divided and randomized into study and control groups, thirty-six patients for each. In study group the ARM procedure was done by injecting 2.5 ml of methylen blue dye intra-dermally and subcutaneously in the upper inner ipsilateral arm along the medial intramuscular groove before ALND. Operative and post-operative results were recorded. Follow up was 6 to 24 months. Results: ARM procedure and successful visualization of arm lymphatics was achieved in 31 patients (86.1%). Statistically there was no significant difference between the two groups regarding patient and tumour characteristics, operative time and number of excised L.Ns. There was significant difference favouring the ARM group in decreasing the incidence of seroma (p= 0.040), lymphedema (p= 0.031) and time passed till remove drains (p <0.001). Conclusions: ARM procedure facilitated arm lymphatics visualization. It is easy non-time-consuming procedure. It resulted in significant reduction in incidence of seroma and lymphedema, with considerable reduction in the overall complications rate.

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