| Endoscopic axillary exploration and sentinel lymphadenectomy. | |
| | |
MedLine Citation:
|
PMID: 9869687 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Minimally invasive approaches have changed the practice of surgery in several specialties. The purpose of this study was to develop a reproducible endoscopic technique for the evaluation of the axilla in breast cancer patients. METHODS: A total of 23 patients with biopsy-proven breast carcinoma were enrolled. Patients were positioned in the supine position with the ipsilateral arm abducted at 90 degrees. A 1-cm skin incision was made at the superior aspect of the axilla. Dissection was carried bluntly to the lateral border of the pectoralis major. A balloon distention device was inserted into the tract and distended under endoscopic vision to create a working space. Insufflation was initiated up to a pressure of 8 mmHg. A 30 degrees laparoscope was introduced for visualization of axillary contents. One or two additional 5-mm cannulas were placed as needed under direct visualization. Manipulation of axillary contents was performed, and in 19 patients a sentinel node identification technique was applied. RESULTS: In all patients, using insufflation and minimal instrument dissection, the axillary vein, long thoracic, and thoracodorsal nerves were found in their usual anatomical locations. Utilizing blunt and sharp dissection, the axilla was thoroughly inspected, and individual lymph nodes were easily identified and extracted. In 11 of 19 patients, a sentinel node or blue dye was identified using isosulfan blue. There was a procedure concordance of 84%, and there were no complications. CONCLUSIONS: We describe a novel endoscopic technique for the evaluation of the axilla in breast cancer patients. This technique allows (a) creation of a minimally invasive working space within the axilla, (b) recognition of key axillary anatomic landmarks, and (c) instrument manipulation within the axilla to identify and extract lymph nodes, and apply the sentinel node technique. This is the first report of a minimally invasive approach to axillary exploration to employ sentinel lymph node mapping. |
| | |
Authors:
|
T N Tsangaris; K Trad; F J Brody; L K Jacobs; N T Tsangaris; J M Sackier |
Related Documents
:
|
7487687 - Outpatient liver biopsy using ultrasound guidance and the biopty gun is safe and cost e... 3496467 - Efficacy and complications of transthoracic needle biopsy of lung in patients with pneu... 21328677 - Totally robotic single-position 'flip' arm technique for splenic flexure mobilizations ... 17179057 - Complications of colonoscopy in an integrated health care delivery system. 14513967 - Thyroplasty revisions: frequency and predictive factors. 7082167 - Ultrasonic imaging during vascular surgery. |
Publication Detail:
|
Type: Clinical Trial; Journal Article |
Journal Detail:
|
Title: Surgical endoscopy Volume: 13 ISSN: 0930-2794 ISO Abbreviation: Surg Endosc Publication Date: 1999 Jan |
Date Detail:
|
Created Date: 1999-02-18 Completed Date: 1999-02-18 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8806653 Medline TA: Surg Endosc Country: GERMANY |
Other Details:
|
Languages: eng Pagination: 43-7 Citation Subset: IM |
Affiliation:
|
Department of Surgery, the Washington Institute of Surgical Endoscopy, and the Breast Care Center, The George Washington University, 2150 Pennsylvania Avenue, N.W., Washington, DC 20037, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Axilla Biopsy, Needle Breast Neoplasms / pathology*, surgery Endoscopy* Female Humans Lymph Node Excision / methods* Lymph Nodes / pathology* Lymphatic Metastasis / diagnosis Sensitivity and Specificity Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Laparoscopic adrenalectomy for benign adrenal neoplasms.
Next Document: Percutaneous cholecystostomy and endoscopic cholecystolithotripsy in the management of acute cholecy...