The Journal of the American Association of Gynecologic Laparoscopists
Original ArticlesComparison of Classic and Endoscopic Lymphadenectomy for Staging Breast Cancer
Section snippets
Materials And Methods
We compared endoscopic and conventional lymph node dissection in 80 women with primary breast cancer to determine advantages and limitations of both procedures especially with regard to postoperative changes. Inclusion criteria were histopathologic confirmation as well as negative clinical and sonographic lymph node status (<1 cm). Consecutive patients were randomized into one of two groups in order of enrollment. Women in group A (mean age 64.9 yrs, range 41–92 yrs) underwent conventional
Results
Operating time was 36 minutes (range 19–66 min) in group A and 62 minutes (range 42–126 min) in group B. Operating time after 50 patients (learning curve) was 36 minutes (range 24–85 min)/10 extirpated nodes starting with insertion of the optic and ending with skin closure.
Analysis of tumor stage in both groups showed comparable results (Table 1). In group A the mean number of collected lymph nodes from levels 1 and 2 was 12 (range 1–22). In group B the number was 11 (4–21).
On three-dimensional
Discussion
In this comparison of endoscopic and conventional axillary lymphadenectomy we found differences in short-term side effects possibly due to better preservation of fine axillary structures by the former method. The endoscopic technique caused less shoulder stiffness. Neurologic complaints such as paresthesia were more common in group B, however, but more shoulder-arm pain was seen in group A. These side effects were documented within the first 6 postoperative weeks. After 3 months there were no
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