Clinical study of one-stage lymphatics-venous anastomosis to prevent upper extremity lymphedema of breast cancer after radical resection

Abstract

Objective To investigate the value of one-stage lymphatics-venous anastomosis in radical mastectomy of breast cancer to prevent post-mastectomy upper limb lymphedema. Methods Ninety patients requiring radical mastectomy of breast cancer in Tangshan Tumor Hospital Affiliated to North China University of Science and Technology from March 2010 to May 2013 were collected as the objects. They were divided into the control group (45 cases) and the treatment group (45 cases) using block randomized grouping (concealment of allocation). Both groups underwent radical mastectomy of breast cancer, and the treatment group was treated with one-stage lymphatics-venous anastomosis on the basis of radical mastectomy. The operation times, amount of bleeding, hospitalization times, postoperative complications and the numbers of axillary lymph node dissection of the patients in the two groups were compared, and the postoperative upper limb lymphedema incidence rates of the patients in the two groups were compared. Results The operative times of the patients in the treatment group and the control group were (152.82±18.76)min and (78.92±10.33)min respectively, and amount of bleeding were (416.64±94.65)ml and (250.84±63.17)ml, with statistical significances (t=-20.39, P=0.00; t=-4.48, P=0.00). The average hospitalization times of the patients in the treatment group and the control group were (14.91±5.44)d and (13.45±2.36)d respectively, the numbers of axillary lymph node dissection were 14.63±3.37 and 14.37±3.18, the numbers of postoperative complications occurred were 9 cases (20.00%) and 5 cases (11.11%), with no statistical significances (t=-0.47, P=0.64; t=0.75, P=0.46; χ2=1.35, P=0.38). Compared with the control group, the treatment group has lower incidence of upper extremity lymphedema (13.95% vs. 40.91%) and lower swelling degree, with statistical significance (χ2=8.48, P=0.03). Conclusion One-stage lymphatics-venous anastomosis in radical mastectomy of breast cancer can effectively transfer lymph diversion to the venous circulation and reduce the incidence of limb lymphedema, which has significant preventive effect. Key words: Breast neoplasms; Lymphedema; Mastectomy, radical; Anastomosis, surgical