Annali italiani di chirurgia
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Lymphedema secondary to breast cancer treatment: possibility of diagnostic and therapeutic prevention].
We performed a prospective randomized study upon 50 patients who had undergone a breast cancer treatment, considering particularly the possibility of appearance of arm secondary lymphedema. The patients were divided in two groups of 25 patients each. In the 1st group, we performed only a clinical follow-up, whilst in the 2nd one, we used also lymphoscintigraphy. ⋯ Lymphoscintigraphy allows to pointout alterations of lymphatic drainage before the clinical appearance of edema. Preventive physical and rehabilitative measures allows to reduce the clinical appearance of lymphedema significantly. Microsurgical operation performed precociously, at the early stages of the disease, permits to obtain the complete regression of the pathology thanks to the repair of preferential lymphatic pathways before of fibrosclerotic tissural alterations occur, which cause progressive worsening of clinical conditions, together with recurrent attacks of acute lymphangitis.
-
After some preliminary remarks upon pathophysiologic and anatomo-surgical aspects, the main complications of axillary lymph-nodal dissection for breast cancer treatment are reported. The role of surgical technique is particularly underlined and also the importance of proper management of wound and surgical drainage post-operatively are pointed out. Author describes, finally, the necessity of an adequate knowledge of lymphatic drainage not only of mammary region, but also of surrounding area, in order to prevent lesions to lymphatic pathways, particularly to those draining upper arm at the same site of breast cancer.