Late Shoulder-Arm Morbidity Using Ultrasound Scalpel in Axillary Dissection for Breast Cancer: A Retrospective Analysis
| Autor: | Gianluca Gatta, Giulio Antoniol, Francesco Iovino, Alfonso Barbarisi, Pasquale Pio Auriemma, Luca Dani |
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| Přispěvatelé: | Iovino, Francesco, Gatta, Gianluca, Auriemma, Pasquale Pio, Dani, Luca, Antoniol, Giulio, Barbarisi, Alfonso |
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Shoulder Time Factors Breast Cancer Lymphedema Harmonic scalpel Breast Neoplasms Axillary dissection 03 medical and health sciences 0302 clinical medicine Breast cancer Bursitis Cost Savings Ultrasonic Surgical Procedures medicine Humans Range of Motion Articular Mastectomy Aged Retrospective Studies Aged 80 and over Pain Postoperative Shoulder morbidity business.industry Sentinel Lymph Node Biopsy Ultrasound Frozen shoulder Middle Aged medicine.disease Surgery body regions Axilla medicine.anatomical_structure Lymphedema Seroma Treatment Outcome 030220 oncology & carcinogenesis Lymphatic Metastasis Arm 030211 gastroenterology & hepatology Axillary Dissection Female business Follow-Up Studies |
| Zdroj: | The Journal of surgical research. 233 |
| ISSN: | 1095-8673 |
| Popis: | We aimed to assess whether the use of the harmonic scalpel (HS) in axillary dissection would reduce long-term shoulder-arm morbidity compared to traditional instruments (TIs). Background: We aimed to assess whether the use of the harmonic scalpel (HS) in axillary dissection would reduce long-term shoulder-arm morbidity compared to traditional instruments (TIs).Materials and methods: A retrospective analysis on 180 patients who underwent standard axillary dissection for breast cancer between 2007 and 2015 was carried out. All patients were evaluated for postoperative pain, impairment of shoulder-arm mobility, seroma formation in axilla, frozen shoulder, and lymphedema.Results: HS procedure on average was 50% shorter compared to the TI technique. HS reduced by 4.5 times the risk of axillary seroma. TIs were associated with 4 times higher risk of developing a painful frozen shoulder.Conclusions: Use of the HS was associated with reduced costs and a positive long-term effect on shoulder-arm morbidity. Axillary seromas are not the only reason of later postoperative shoulder-arm morbidity: other mechanisms are hypothesized in the onset of this very disabling disorder. (C) 2018 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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