Document Detail

Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer.
MedLine Citation:
PMID:  19591159     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The physiological disturbances leading to lymphoedema after breast cancer surgery are poorly understood. Damage to sympathetic nerves during axillary lymph node dissection (ALND), leading to increased capillary fluid filtration, was investigated as a possible contributory factor.
METHODS: The integrity of the upper limb sympathetic nervous system was tested in 36 patients before, and 3 and 12 months after ALND. Forearm vascular resistance (FVR), calculated from forearm blood flow and mean systemic arterial pressure, was measured before and after exposure to lower-body negative pressure. Forearm venous compliance was measured using (99m)Tc-labelled autologous erythrocytes and radionuclide plethysmography before and after cold water immersion of the feet.
RESULTS: There were clear changes in FVR and venous compliance in response to sympathetic stimulation but no differences attributable to surgery or between the nine patients who developed lymphoedema and the 27 who did not; nor were there differences between the two arms. There was a trend towards lower preoperative FVR in patients who developed lymphoedema.
CONCLUSION: Lymphoedema is not the result of sympathetic nerve damage sustained during ALND. Preoperative FVR may help predict who will get lymphoedema following this surgery.
T M Bennett Britton; S M L Wallace; I B Wilkinson; P S Mortimer; A M Peters; A D Purushotham
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  96     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-15     Completed Date:  2009-08-27     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  865-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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MeSH Terms
Aged, 80 and over
Breast Neoplasms / surgery*
Forearm / blood supply
Lymph Node Excision / adverse effects*
Lymphedema / etiology*
Middle Aged
Postoperative Period
Preoperative Care
Sympathetic Nervous System / injuries*
Trauma, Nervous System / etiology*
Vascular Resistance / physiology
Grant Support
FS/07/001/21990//British Heart Foundation; //Wellcome Trust

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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