• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.947-950
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• 2013

Background: We performed this meta-analysis to assess the effectiveness and safety of axillary dissection in old women. Methods: The Cochrane Library, PubMed, EMBASE and Chinese Biomedical Literature Database were searched and all randomized controlled trials of axillary dissection in old women (at least 60 years old) were considered. Meta-analyses were completed using RevMan5.1. Results: Three eligible randomized controlled trials (RCTs) including 5,337 patients were considered. There was weak evidence in favour of axillary dissection (AD) in old women. The meta-analysis showed that the overall survival (OS) after 1, 3, 5 and 7 years and the disease free survival (DFS) after 1, 3 and 5 year were not statistically significantly different between AD and no AD groups. However, there was a difference in the 7 year DFS. Conclusions: Axillary dissection did not provide survival benefit to the old women with breast cancer analysed. Therefore, axillary dissection is not well-indicated in old women with breast cancer.

• Journal of Chest Surgery
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• 제44권5호
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• pp.338-342
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• 2011

Background: The axillary artery is frequently used for cardiopulmonary bypass, especially in acute aortic dissection. We have cannulated the axillary artery using a side graft or by directly using Seldinger's technique. The purpose of this study was to assess the technical problems and complications of both cannulation techniques. Materials and Methods: From January 2003 to December 2009, 53 patients underwent operations using the axillary artery for arterial cannulation. The axillary artery was cannulated with a side graft in 35 patients (side graft group) and directly using Seldinger's technique in 18 patients (direct group). Results: The results were compared between two groups, focusing on cannulation-related morbidities including neurologic morbidity. Arterial damage or dissection of the axillary artery occurred in 1 (2.9%) patient in the side graft group and in 1 (5.6%) patient in the direct group. Malperfusion and insufficient flow did not occur in either group. There were no postoperative complications related to axillary cannulation, such as brachial plexus injury, compartment syndrome, or local wound infection, in either group. Conclusion: Technical problems and complications of the axillary arterial cannulation in both techniques were rare. Direct arterial cannulation using Seldinger's technique was done safely and more simply than the previous technique. It was concluded that both axillary arterial cannulation techniques are acceptable and it remains the surgeon's preference which technique should be used.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.430-435
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• 2022

Objective: This study was conducted to investigate the effect of active movement with skin mobilization on range of motion, pain, and rating of perceived exertion in patients diagnosed with axillary web syndrome after axillary lymph node dissection. Design: A Case report Methods: It was performed on 7 patients diagnosed with axillary web syndrome after lymph node dissection. The subjects experienced a decrease in the range of joint motion and pain in movement when raising their arms in their daily lives, and complained of discomfort. The active range of motion, numeric rating scale, and modified Borg scale of shoulder joint flexion were measured, and the differences after active movement with skin mobilization were compared. Results: All subjects increased by 24.9 degree on average in active range of motion after active movement with skin mobilization intervention. There was no pain in the maximum range of joint motion measured before intervention, and rating of perceived exertion was significantly reduced. Conclusions: Active movement with skin mobilization can be a very useful way to help improve and treat axillary web syndrome, and it is recommended for improving the function and quality of life of axillary web syndrome patients. and It is also believed that it can be used steadily at home through the education of patients and families.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1181-1185
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• 2016

Background: The aim of this study is to compare the numbers of axillary lymph nodes (ALN) taken out by dissection between patients with breast cancer operated on after having neoadjuvant chemotherapy (NAC) treatment and otherswithout having neoadjuvant chemotherapy, and to investigate factors affecting lymph node positivity. Materials and Methods: A total of 49 patients operated due to advanced breast cancer after neoadjuvant chemotherapy and 144 patients with a similar stage of the cancer having primary surgical treatment without chemotherapy at the general surgery clinic of Ondokuz Mayis University Medicine Faculty between the dates 01.01.2006 and 31.10.2012 were included in the study. The total number of lymph nodes taken out by axillary dissection (ALND) was categorized as the number of positive lymph nodes and divided into <10 and ${\geq}10$. The variables to be compared were analysed using the program SPSS 15.0 with P<0.05 accepted as significant. Results: Median number of dissected lymph nodes from the patient group having neoadjuvant chemotherapy was 16 (16-33) while it was 20 (5-55) without chemotherapy. The respective median numbers of positive lymph nodes were 5 (0-19) and 10 (0-51). In 8 out of 49 neoadjuvant chemotherapy patients (16.3%), the number of dissected lymph nodes was below 10, and it was below 10 in 17 out of 144 primary surgery patients. Differences in numbers of dissected total and positive lymph nodes between two groups were significant, but this was not the case for numbers of <10 lymph nodes. Conclusions: The number of dissected lymph nodes from the patients with breast cancer having neoadjuvant chemotherapy may be less than without chemotherapy. This may not always be attributed to an inadequate axillary dissection. More research to evaluate the numbers of positive lymph nodes are required in order to increase the reliability of staging in the patients with breast cancer undergoing neoadjuvant chemotherapy.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.545-552
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• 2008

Purpose: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. Methods: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350 cc. Through a 4 cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. Results: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. Conclusion: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5731-5734
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• 2013

Background: The object of this study was to examine whether a new protocol including step-sectioning and immunohistochemistry (IHC) staining of axillary sentinel nodes (SN) would lead to detection of more metastases in patients with breast cancer. Materials and Methods: Sixty-nine tumor free sentinel lymph nodes were examined. Step frozen sectioning was performed on formalin fixed SN and stained both by hematoxylin and eosin (H and E) and cytokeratin markers using IHC. Any tumoral cell in IHC stained slides were considered as a positive result. Metastases up to 0.2 mm were considered as isolated tumor cells and 0.2 up to 2 mm as micrometastasis. Results: Mean age of the patients was $48.7{\pm}12.2$ years. Step sectioning of the SN revealed 11 involved by metastasis which was statistically significant (p<0.001). Furthermore, 15 (21.7%) of the patients revealed positive results in IHC staining for pan-CK marker and this was also statistically significant (p=0.001). Ten patients had tumoral involvement in lymph nodes harvested from axillary dissection and 4 out of 15 lymph nodes with positive result for CK marker were isolated tumor cells. However, 4 of 10 patients with tumor positive lymph nodes in axillary dissection were negative for CK marker and in contrast 6 of the pan-CK positive SN were in patients with tumor-free axillary lymph nodes. Conclusions: Both IHC and step sectioning improve the detection rate of metastases. Considering the similar power of these two methods, we recommend using either IHC staining or step sectioning for better evaluation of harvested SNs.

• 대한한의정보학회지
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• 제14권2호
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• pp.95-103
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• 2008

Objectives : The purpose of this case is to report the improvement of a patient with lymphedema due to axillary lymph node dissection after acupuncture therapy and herbal medicine. Methods : We treated the patient with Dong-Qi acupuncture, herbal medication(木通大安湯), lymph absorption massage, compresses, abdominal breathing. We measured the circumference of the patient's elbow and wrist every day at 6pm. Results : Since being hospitalized, the circumference of the patient' elbow and wrist has been decreased and VAS score has gotten lower gradually. Conclusions : We considered Dong-Qi acupuncture, herbal medication had a useful effect on lymphedema due to axillary lymph node dissection with lymph absorption massage, compresses, abdominal breathing.

• Journal of Chest Surgery
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• 제36권5호
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• pp.343-347
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• 2003

배경: 급성 상행대동맥박리증 수술 시 대퇴동맥이 동맥삽관 장소로 주로 이용되어 왔으나 최근 관류 장애 및 역행성 색전증의 발생 위험이 적은 액와동맥삽관이 증가하고 있다. 이에 기존의 대퇴동맥 삽관술과 액와동맥 삽관술을 이용한 수술성적을 비교하여 액와동맥 삽관술의 안전성과 유용성을 고찰하고자 하였다. 대상 및 방법: 1995년 10월부터 2001년 9월까지 급성 상행대동맥박리증으로 수술을 받은 71명을 대상으로 의무기록을 후향적으로 검토하여 수슬 전의 상태, 수술범위 및 방법, 수술 후 경과를 분석하였다. 대퇴동맥삽관은 40명으로 평균 연령은 57세, 액와동맥삽관은 31명으로 평균 56세였다. 결과: 액와동맥군의 평균 체외순환시간과 순환정지시간은 각각 207분과 39분으로 대퇴동맥군의 263분과 49분보다 의미있게 짧았고(p<0.05), 수술 후 입원기간 역시 액와동맥군에서 15일로 대퇴동맥군의 35일에 비하여 의미있게 단축되었다(p<0.05). 수술 후 사망률(액와동맥군 6.5%, 대퇴동맥군 10%)과 영구적 신경계 합병증 발생률(액와동맥군 3.2%, 대퇴동맥군 2.5%)은 의미있는 차이를 보이지 않았으나 일시적 신경계 합병증의 발생률은 액와동맥군에서 12.9%, 대퇴동맥군에서 25%로 의미있는 차이를 보였다(p<0.05). 대퇴동맥군 중 2명의 환자에서 수술 중 대동맥궁 분지의 관류 부전이 발견되어 삽관 위치의 변경이 필요하였다. 액와동맥 삽관에 따른 합병증으로는 1명의 환자가 정중신경 손상을 경험하였다. 결론: 급성 상행대동맥박리증 수술에서 액와동맥 삽관은 뇌허혈시간의 단축과 이에 따른 수술 후 신경계 합병증의 발생률을 낮추는 데 기여하는 안전한 술식으로 판단된다. 또한, 이에 따라 대동맥궁에 내피 손상부위가 있는 환자에 대하여 보다 적극적이고 광범위한 수술 적용을 가능하게 한 것으로 판단된다.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.301-303
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• 2010

Purpose: The axillary web syndrome (AWS) is a selflimiting cause of morbidity in the early postoperative period after axillary surgery. This article presents a rare complication developed after surgical treatment for axillary osmidrosis. Methods: A 55-year-old male patient underwent surgical excision of skin and glandular tissue for axillary osmidrosis. Three weeks after the surgery, he visited our department due to a visible web of left axillary skin overlying palpable cord extends into the medial ipsilateral arm. There was a taut and tender cord of tissue under the skin and shoulder abduction was limited to less than 90 degrees. He was diagnosed with AWS and treated with conservative management. Results: Four months later, AWS resolved completely without any treatment and patient was free of pain or motion restriction. Conculsion: Axillary web syndrome has been described as frequent complication after axillary lymph node dissection or sentinel node biopsy, but not after surgical treatment of axillary osmidrosis. Surgeons must be aware of the risk of axillary web syndrome after treatment of axillary osmidrosis.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.464-470
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• 2022

Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case report Methods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.