Hand (New York, N.Y.) · 2026
The Risk of Lymphedema in Elective Hand Surgery After Axillary Lymph Node Sampling: A Prospective, Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Odum Susan M, Sabbag Casey, Hammert Warren, Lewis Daniel R, Loeffler Bryan J, Chadderdon Christopher, Chung Kevin C, Lehman Thomas, Gaston R Glenn
Аннотация
BACKGROUND: The purpose of this prospective cohort study was to evaluate the risk of lymphedema and perioperative complications in patients undergoing elective upper-extremity surgery with a history of breast cancer and ipsilateral lumpectomy/mastectomy with axillary lymph node sampling.
METHODS: Validated volumetric measurements of the limb were obtained presurgery and postsurgery. All complications were recorded. A total of 104 patients enrolled prospectively, and 78 met inclusion criteria with 30 patients in the no tourniquet group and 48 in the tourniquet group. Patients were followed up at 2-week, 6-week, 3-month, 6-month and 12-month intervals. The median number of lymph nodes dissected was 8 (no tourniquet), compared to 7 (tourniquet). Sixty-six percent (no tourniquet) and 58% (tourniquet) had previous radiation. Twenty-eight percent (no tourniquet) and 31% (tourniquet) had previous history of lymphedema. Eight patients (9%) had been previously advised to never have surgery on the involved limb.
RESULTS: There were 3 cases of lymphedema at 2 weeks: 2 patients (no tourniquet) and 1 patient (tourniquet). One patient (no tourniquet) had lymphedema at 2 weeks; only that resolved at 6 weeks. Additional complications include 1 patient (no tourniquet) had pin displacement after distal radius fixation at 2 weeks, 1 patient (tourniquet) had postoperative hematoma after a mass excision, and 1 patient (tourniquet) had hand stiffness following carpal tunnel release. Patient satisfaction between the two groups was high and not statistically different at any time point.
CONCLUSIONS: Surgery in patients with a history of breast cancer with lymph node sampling appears to be equally safe with or without the use of a tourniquet and carries a low rate of overall complications, including exacerbation of their lymphedema.
METHODS: Validated volumetric measurements of the limb were obtained presurgery and postsurgery. All complications were recorded. A total of 104 patients enrolled prospectively, and 78 met inclusion criteria with 30 patients in the no tourniquet group and 48 in the tourniquet group. Patients were followed up at 2-week, 6-week, 3-month, 6-month and 12-month intervals. The median number of lymph nodes dissected was 8 (no tourniquet), compared to 7 (tourniquet). Sixty-six percent (no tourniquet) and 58% (tourniquet) had previous radiation. Twenty-eight percent (no tourniquet) and 31% (tourniquet) had previous history of lymphedema. Eight patients (9%) had been previously advised to never have surgery on the involved limb.
RESULTS: There were 3 cases of lymphedema at 2 weeks: 2 patients (no tourniquet) and 1 patient (tourniquet). One patient (no tourniquet) had lymphedema at 2 weeks; only that resolved at 6 weeks. Additional complications include 1 patient (no tourniquet) had pin displacement after distal radius fixation at 2 weeks, 1 patient (tourniquet) had postoperative hematoma after a mass excision, and 1 patient (tourniquet) had hand stiffness following carpal tunnel release. Patient satisfaction between the two groups was high and not statistically different at any time point.
CONCLUSIONS: Surgery in patients with a history of breast cancer with lymph node sampling appears to be equally safe with or without the use of a tourniquet and carries a low rate of overall complications, including exacerbation of their lymphedema.