Diagnosis and treatment of breast cancer with central and medial localization using video-assisted thoracoscopic parasternal lymphadenectomy
Istagilov, A.K.; Sigal, E.I.; Khamidullin, R.G.; Nagumanov, E.V.; Gubaĭdullin, K.M.
Voprosy Onkologii 47(3): 348-355
2001
ISSN/ISBN: 0507-3758 PMID: 11544837 Document Number: 526837
Since extended mastectomy after Urban involves an unjustifiably high level of trauma, this method has limited application. We have evolved a procedure of video-assisted thoracoscopic parasternal lymphadenectomy (VATPL). On completion of the experimental part using cadavers to work out the rationale for extent of surgery, clinical trials started. A total of 120 operations in patients aged 27-73 were performed (left-sided--64, right-sided--56), with the number of lymph nodes removed in each case ranging 1-10. Metastases were detected in 23 (19.2%), isolated lesions (metastases to parasternal lymph nodes alone)--6 (5.0%). With volume of removed tissue being identical, the findings on level of pain, amount of narcotic analgetics, hospital stay duration, intra- and postoperative complication incidence and cardiointervalography and pneumotachometry for VATPL patients were significantly better than for those treated by traditional (open-chest) procedure. It is concluded that VATPL is a highly effective and low-traumatizing diagnostic method. It may be recommended as an operation of choice for parasternal lymph collector involvement of central or medial localization.