Endoscopic axillary surgery in breast cancer

Background: The aim was to provide an assessment of the current status of e ndoscopic axillary surgery in patients with breast cancer. Methods: Fifty-three patients underwent endoscopic lymphadenectomy. The sur gical efficiency (operating time, number of resected nodes, intraoperative and postoperative complications), short-term morbidity (duration of drainag e, total lymph flow, seroma rate) and long-term outcome (pain, numbness, mo bility, strength, oedema) were assessed. The incidence and severity of diff erent arm symptoms were compared with the results of 396 patients treated w ith a conventional axillary procedure. Finally, all available data relating to endoscopic axillary surgery were reviewed. Results: The operating time ranged from 60 to 150 min. A mean 17 (range 10- 28) lymph nodes was resected. The extent of postoperative lymphorrhoea (mea n 372 ml) and the seroma rate (eight of 34 patients) were not significantly reduced in comparison with conventional surgery. The assessment of long-te rm morbidity revealed fewer disturbances of sensitivity and a decreased rat e of severe symptom intensity for pain, oedema and complaints related to mo bility. Conclusion: Despite excellent visualization of anatomical landmarks and imp roved long-term morbidity, endoscopic lymph node dissection cannot be regar ded as a suitable technique for routine axillary management in breast cance r because of long operating times.