Elective hand surgery in the breast cancer patient with prior ipsilateral axillary dissection
Identifieur interne : 004881 ( Istex/Checkpoint ); précédent : 004880; suivant : 004882Elective hand surgery in the breast cancer patient with prior ipsilateral axillary dissection
Auteurs : William J. Dawson ; Douglas R. Elenz [États-Unis] ; David P. Winchester ; Joseph L. FeldmanSource :
- Annals of Surgical Oncology [ 1068-9265 ] ; 1995-03-01.
Abstract
Abstract: Background: We wished to determine if complications after elective hand surgery were greater in women with previous mastectomy and axillary dissection than in those without. Methods: We surveyed records of all women undergoing carpal tunnel release by the senior author (W.J.D.) from 1983 to 1993. The postaxillary dissection group (group A) was made up of 15 women; seven had some postdissection lymphedema. Group B was made up of 302 other patients who had not undergone breast surgery or axillary dissection. Anesthetic and surgical techniques were identical for both groups, with i.v. regional anesthesia used most commonly. Results: No patient in the axillary dissection group developed any postoperative infection or had any worsening of preexisting lymphedema or onset of new arm swelling after ipsilateral carpal tunnel release. The nonaxillary dissection group had a postoperative infection rate of 3.6%; all infections were superficial and resolved with conservative therapy. In addition, 31 women experienced other complications, including 13 with hand/finger stiffness and four with reflex dystrophy. Fifteen required formal hand therapy. Conclusions: Women with prior ipsilateral axillary dissection can safely undergo elective upper extremity surgery, provided strict sterile technique and appropriate anesthetic and surgical precautions are observed. Patients having undergone previous axillary dissection should not be prohibited from future limb manipulations, including venepunctures, blood pressure measurements, or elective surgery.
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DOI: 10.1007/BF02303628
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Elective hand surgery in the breast cancer patient with prior ipsilateral axillary dissection</title><author><name sortKey="Dawson, William J" sort="Dawson, William J" uniqKey="Dawson W" first="William J." last="Dawson">William J. Dawson</name></author><author><name sortKey="Elenz, Douglas R" sort="Elenz, Douglas R" uniqKey="Elenz D" first="Douglas R." last="Elenz">Douglas R. Elenz</name></author><author><name sortKey="Winchester, David P" sort="Winchester, David P" uniqKey="Winchester D" first="David P." last="Winchester">David P. Winchester</name></author><author><name sortKey="Feldman, Joseph L" sort="Feldman, Joseph L" uniqKey="Feldman J" first="Joseph L." last="Feldman">Joseph L. 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Dawson</name><affiliation></affiliation><affiliation><wicri:noCountry code="subField">Evanston</wicri:noCountry></affiliation></author><author><name sortKey="Elenz, Douglas R" sort="Elenz, Douglas R" uniqKey="Elenz D" first="Douglas R." last="Elenz">Douglas R. Elenz</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, Northwestern University McGraw Medical Center, Chicago, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Winchester, David P" sort="Winchester, David P" uniqKey="Winchester D" first="David P." last="Winchester">David P. Winchester</name><affiliation></affiliation><affiliation><wicri:noCountry code="subField">Evanston</wicri:noCountry></affiliation></author><author><name sortKey="Feldman, Joseph L" sort="Feldman, Joseph L" uniqKey="Feldman J" first="Joseph L." last="Feldman">Joseph L. Feldman</name><affiliation></affiliation><affiliation><wicri:noCountry code="subField">Evanston</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Surgical Oncology</title><title level="j" type="abbrev">Annals of Surgical Oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>New York</pubPlace><date type="published" when="1995-03-01">1995-03-01</date><biblScope unit="volume">2</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="132">132</biblScope><biblScope unit="page" to="137">137</biblScope></imprint><idno type="ISSN">1068-9265</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1068-9265</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Background: We wished to determine if complications after elective hand surgery were greater in women with previous mastectomy and axillary dissection than in those without. Methods: We surveyed records of all women undergoing carpal tunnel release by the senior author (W.J.D.) from 1983 to 1993. The postaxillary dissection group (group A) was made up of 15 women; seven had some postdissection lymphedema. Group B was made up of 302 other patients who had not undergone breast surgery or axillary dissection. Anesthetic and surgical techniques were identical for both groups, with i.v. regional anesthesia used most commonly. Results: No patient in the axillary dissection group developed any postoperative infection or had any worsening of preexisting lymphedema or onset of new arm swelling after ipsilateral carpal tunnel release. The nonaxillary dissection group had a postoperative infection rate of 3.6%; all infections were superficial and resolved with conservative therapy. In addition, 31 women experienced other complications, including 13 with hand/finger stiffness and four with reflex dystrophy. Fifteen required formal hand therapy. Conclusions: Women with prior ipsilateral axillary dissection can safely undergo elective upper extremity surgery, provided strict sterile technique and appropriate anesthetic and surgical precautions are observed. Patients having undergone previous axillary dissection should not be prohibited from future limb manipulations, including venepunctures, blood pressure measurements, or elective surgery.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li></region></list><tree><noCountry><name sortKey="Dawson, William J" sort="Dawson, William J" uniqKey="Dawson W" first="William J." last="Dawson">William J. Dawson</name><name sortKey="Feldman, Joseph L" sort="Feldman, Joseph L" uniqKey="Feldman J" first="Joseph L." last="Feldman">Joseph L. Feldman</name><name sortKey="Winchester, David P" sort="Winchester, David P" uniqKey="Winchester D" first="David P." last="Winchester">David P. Winchester</name></noCountry><country name="États-Unis"><region name="Illinois"><name sortKey="Elenz, Douglas R" sort="Elenz, Douglas R" uniqKey="Elenz D" first="Douglas R." last="Elenz">Douglas R. Elenz</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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