Evaluation the effect of preserving intercostobrachial nerve in axillary dissection for breast cancer patient
| Autor: | Monchai Leesombatpaiboon, Panuwat Lertsithichai, Chairat Supsamutchai, Methas Arunnart, Prakasit Chirappapha, Thongchai Sukarayothin |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Axillary Lymph Node Dissection Physical examination Sensory loss Sensory system medicine.disease 03 medical and health sciences 0302 clinical medicine Breast cancer Quality of life 030220 oncology & carcinogenesis Sensation Physical therapy Medicine Surgery Original Article 030212 general & internal medicine Intercostobrachial nerve business |
| Popis: | Background: The Intercostobrachial nerve (ICBN) is responsible for sensory function in the axillar and upper arm. The majority of surgeons routinely sacrifice the ICBN during axillary lymph node dissection (ALND) because of technical difficulties. Therefore, the aim of this study was to assess the effects of the preservation or division of the ICBN on the incidence of post-operative sensory disturbance, health-related quality of life (HRQOL), and the physical functions of the upper limbs. Methods: We performed a randomized double-blind trial comparing the incidence of sensory disturbance, HRQOL and physical functions of upper limbs in the preservation and the removal of the ICBN. Clinicians performed sensory evaluation at 2 weeks and 3 months after surgery. The sensory evaluation included questionnaires (subjective evaluation) and physical examination (objective evaluation) to evaluate sensory disturbance of the upper arm. HRQOL and physical function of upper limbs was accessed before surgery and at three months after surgery, using Short Form-36 and QuickDASH questionnaires, both in Thai language versions. Results: At the end of the surgical procedures there were 15 patients in the preserved group (group P) and 28 patients in the non-preserved group (group N). In as-treated analysis, there was no significant difference between the groups in pain, sensory loss, physical examination of touch and pinprick sensation, and areas of sensory dullness. HRQOL found that the reported pain in P group was higher than N group in both intention-to-treat and as-treated analysis. In the QuickDASH scores of physical functions of the upper limbs there was a significant difference, 9.1 in group P and 20.5 in group N (P=0.013). Conclusions: ICBN preservation provides no benefit to improving sensation, but there are benefits in HRQOL and physical functions of upper limbs at three months after surgery. |
| Databáze: | OpenAIRE |
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