Objective: Assessment of axillary nodal status with reduced shoulder-arm-morbidity remains a major challenge for primary surgery of breast cancer patients. In a pilot study endoscopic axillary lymph node dissection was evaluated.
Material and methods: In 30 breast cancer patients axillary lymphadenectomy was performed after liposuction using an endoscopic approach. During a learning phase of 15 cases an open revision was routinely carried out. Later complete endoscopic lymph node dissection was performed. The exposition of anatomical landmarks, the number of resected lymph nodes, postoperative lymphorrhea, histopathological signs of traumatisation were assessed as well as intra and postoperative complications.
Results: In any case we found excellent exposure of anatomical landmarks. Following a learning curve of 15 cases the average number of resected lymph nodes was equal to the average number of lymph nodes resected with conventional techniques (18.2 vs. 18.4, median 17 vs 18). Minimal intraoperative complications were observed. Postoperative lymphorrhea and seroma rate were not remarkably reduced in comparison with open procedures.
Conclusions: Our study demonstrates, that endoscopic lymph node dissection may be performed with a low complication rate and with identical accuracy as achieved by open techniques.