Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®
Identifieur interne : 005102 ( Main/Merge ); précédent : 005101; suivant : 005103Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®
Auteurs : Katherine T. Ostapoff ; David Euhus ; Xian-Jin Xie ; Madhu Rao ; Amy Moldrem ; Roshni RaoSource :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2011.
Abstract
For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND) is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus®, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus® will decrease operative time and reduce post-operative complications.
Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study.
Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups.
In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.
Url:
DOI: 10.1186/1477-7819-9-90
PubMed: 21843361
PubMed Central: 3170616
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Ostapoff</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Euhus, David" sort="Euhus, David" uniqKey="Euhus D" first="David" last="Euhus">David Euhus</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Xie, Xian Jin" sort="Xie, Xian Jin" uniqKey="Xie X" first="Xian-Jin" last="Xie">Xian-Jin Xie</name><affiliation><nlm:aff id="I2">Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Rao, Madhu" sort="Rao, Madhu" uniqKey="Rao M" first="Madhu" last="Rao">Madhu Rao</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Moldrem, Amy" sort="Moldrem, Amy" uniqKey="Moldrem A" first="Amy" last="Moldrem">Amy Moldrem</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Rao, Roshni" sort="Rao, Roshni" uniqKey="Rao R" first="Roshni" last="Rao">Roshni Rao</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21843361</idno><idno type="pmc">3170616</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170616</idno><idno type="RBID">PMC:3170616</idno><idno type="doi">10.1186/1477-7819-9-90</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">004670</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004670</idno><idno type="wicri:Area/Pmc/Curation">004669</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004669</idno><idno type="wicri:Area/Pmc/Checkpoint">003082</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003082</idno><idno type="wicri:Area/Ncbi/Merge">004603</idno><idno type="wicri:Area/Ncbi/Curation">004603</idno><idno type="wicri:Area/Ncbi/Checkpoint">004603</idno><idno type="wicri:Area/Main/Merge">005102</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Axillary lymph node dissection for breast cancer utilizing Harmonic Focus<sup>®</sup></title><author><name sortKey="Ostapoff, Katherine T" sort="Ostapoff, Katherine T" uniqKey="Ostapoff K" first="Katherine T" last="Ostapoff">Katherine T. Ostapoff</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Euhus, David" sort="Euhus, David" uniqKey="Euhus D" first="David" last="Euhus">David Euhus</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Xie, Xian Jin" sort="Xie, Xian Jin" uniqKey="Xie X" first="Xian-Jin" last="Xie">Xian-Jin Xie</name><affiliation><nlm:aff id="I2">Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Rao, Madhu" sort="Rao, Madhu" uniqKey="Rao M" first="Madhu" last="Rao">Madhu Rao</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Moldrem, Amy" sort="Moldrem, Amy" uniqKey="Moldrem A" first="Amy" last="Moldrem">Amy Moldrem</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author><author><name sortKey="Rao, Roshni" sort="Rao, Roshni" uniqKey="Rao R" first="Roshni" last="Rao">Roshni Rao</name><affiliation><nlm:aff id="I1">Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9155</nlm:aff><wicri:noCountry code="subfield">USA 75390-9155</wicri:noCountry></affiliation></author></analytic><series><title level="j">World Journal of Surgical Oncology</title><idno type="eISSN">1477-7819</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND) is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus<sup>®</sup>, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus<sup>® </sup>will decrease operative time and reduce post-operative complications.</p></sec><sec><title>Methods</title><p>Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study.</p></sec><sec><title>Results</title><p>Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups.</p></sec><sec><title>Conclusion</title><p>In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Krag, Dn" uniqKey="Krag D">DN Krag</name></author><author><name sortKey="Anderson, Sj" uniqKey="Anderson S">SJ Anderson</name></author><author><name sortKey="Julian, Tb" uniqKey="Julian T">TB Julian</name></author><author><name sortKey="Brown, Am" uniqKey="Brown A">AM Brown</name></author><author><name sortKey="Harlow, Sp" uniqKey="Harlow S">SP Harlow</name></author><author><name sortKey="Costantino, Jp" uniqKey="Costantino J">JP Costantino</name></author><author><name sortKey="Ashikaga, T" uniqKey="Ashikaga T">T Ashikaga</name></author><author><name sortKey="Weaver, Dl" uniqKey="Weaver D">DL 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Riedel</name></author><author><name sortKey="Van Zee, Kj" uniqKey="Van Zee K">KJ Van Zee</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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