ENDOSCOPIC EXPLORATION AND LYMPH-NODE SAMPLING OF THE AXILLA - PRELIMINARY FINDINGS OF A RANDOMIZED PILOT-STUDY COMPARING CLINICAL AND ANATOMOPATHOLOGICAL RESULTS OF ENDOSCOPIC AXILLARY LYMPH-NODE SAMPLING WITH TRADITIONAL SURGICAL-TREATMENT

Objective: To describe the technique of endoscopic exploration of the axilla. To compare this technique to open surgical treatment by compar ing the following variables: operative time, peri-operative complicati ons, duration of hospital stay, node's histology and morphologic aspec ts and esthetic results. Materials: Standard instruments for tradition al operative laparoscopy plus a lipo-aspirator (0.8 Bar). Patients: Fo rty patients, 20 (group A) undergoing open surgery and 20 (group B) un dergoing axilloscopy. All patients with early invasive breast cancer a re eligible for conservative operative treatment. Method: Randomized s tudy. The technique is described and preliminary results are presented . Results: The operative time for axilloscopy is approximately double that for open surgery. A comparable number of lymph nodes is collected by axilloscopy and open surgery. The nodes collected by axilloscopy a re more likely to be fractured. What is the clinical consequence? Two loco-regional relapses are observed in the endoscopic group. Discussio n: Axillary sampling by endoscopic procedure gives the same pathologic information than surgical axillary sampling. Anatomo-pathologic aspec ts of nodes and possibilities of relapses were two drawbacks of this p rocedure. Conclusion: Operative time is increased for axilloscopy comp ared with open surgery. The techniques yield comparable anatomo-pathol ogic results. It is still unknown whether this endoscopic technique is as effective as traditional surgery or if the frequency or severity o f lymphedema is decreased by the endoscopic approach. Copyright (C) 19 96 Elsevier Science Ireland Ltd.