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PubMed1992

[Axillary band contractures after axillary lymph node excision].

Three patients are described who developed painful bands across the axilla which severely restricted shoulder abduction after breast surgery and axillary lymph-node dissection. They were treated by transection of the bands with excellent results in two of the three patients. The underlying pathology is apparently thrombosis, obstruction and inflammation of lymphatic channels. Treatment should be conservative in most cases, with surgery reserved for patients with intolerable symptoms.

Adult↗
PubMed1995

[Adenocarcinoma of the cardia: does the extent of gastric resection and lymph node excision influence survival?].

OBJECTIVES: In the curative treatment of the adenocarcinoma of the cardia (AC), the extent of the esogastrectomy and the need for lymph node dissection are still debated. The palliative treatment of AC is now currently non-surgical. The aim of this study was: a) to assess early results of palliative surgery; b) to evaluate the results of curative resection with reference to the influence of the extent of gastrectomy and lymph node dissection on early results and long-term survival. METHODS: From 1979 to 1989, 179 patients (mean age = 60 +/- 12 years) with AC had 45 palliative resections (mean age = 56 +/- 15) and 134 curative resections (mean age = 61 +/- 12). Thirty-eight proximal subtotal esogastrectomies (PSOG) and 7 total esogastrectomies (TOG) were palliative; 72 PSOG and 62 TOG extended to the spleen were curative and associated with lymphadenectomy. RESULTS: The operative mortality rate was 8.9% regardless of the palliative or curative intent of resection. After palliative resection, the mortality rate was 2.6% (1 case out of 38) after PSOG and 42.9% (3 cases out of 7) after OGT (P = 0.01); the median survival was 8 months. After curative resection, the mortality rate was 12.5% (9 cases out of 72) after PSOG and 4.8% (3 cases out of 62) after extended TOG (P = 0.2); actuarial 5-year survival rate was 42% after PSOG and 39% after extended TOG. CONCLUSIONS: These results suggest that: a) palliative PSOG for AC can be performed with a low mortality; b) resection with extensive lymphadenectomy allows substantial survival regardless of the extent of gastrectomy.

Adenocarcinoma↗
PubMed1995

[Biological glue does not reduce lymphorrhoea after lymph node excision. Randomized prospective study on 40 patients].

The aim of this prospective and randomized study, was to demonstrate the benefit by using fibrin glue after axillary lymph node dissection. From January 1990 to January 1991, forty females were randomized before surgery for breast cancer: 20 patients of the group A underwent additional application of fibrin glue (5 ml containing 500 IU of thrombin) by spray only in the area of axillary dissection, while the 20 patients of group B acted as the control group. The two groups were compared for age, number of nodes removed and involved, drainage volume and duration and complications. Student's t test, Mann and Whitney non parametric test and chi 2 were used when appropriate for statistical analysis. The two groups were well balanced for age, number of nodes removed and involved, staging and histologic findings. The average volume of lymphorrhoea in the lymph node dissection area was greater after use of fibrin glue (410.4 ml) than in controls (275.5 ml, p = 0.016). No difference was noted between the two groups for the volume of drainage of the mastectomy or lumpectomy site or, for the total volume of drainage. Drainage durations as well as hospital stay were similar. Six complications occurred in group A, and one in group B (p = 0.037).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗