Experience of a large series of mastoscopic axillary lymph node dissection

Abstract

Minimally invasive and functional therapy represents an inevitable trend in breast surgery. Improved visualization during mastoscopic axillary lymph node dissection (MALND) realizes a clear exposure of axillary anatomy, but it differs from a general laparoscopic operation. There are some challenges in technique itself which need to be noted. Detailed understanding of the elaborate operative technique, familiarity with the axillary anatomy and accurate adherence to procedure are main elements for successful MALND. Based on our experience of MALND, we have identified several points that are essential in ensuring successful MALND. Five hundred twenty-two patients underwent MALND. The special instruments, axillary anatomic landmarks and operative steps were illuminated. Mean operative time was 39.2 min (range 20-156 min). Operative bleeding was minimal. A mean of 13.4 (range 4-38) lymph nodes were harvested. No intra or post-operation-related complication occurred. No axillary tumor relapse or trocar tumor implantation was identified during follow-up. MALND can be performed with great convenience and safety with adherence to suitable procedures.