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Axillary lymph node dissection for breast cancer utilizing Harmonic Focus
Journal article   Open access   Peer reviewed

Axillary lymph node dissection for breast cancer utilizing Harmonic Focus

Katherine T Ostapoff, David Euhus, Xian-Jin Xie, Madhu Rao, Amy Moldrem and Roshni Rao
World journal of surgical oncology, Vol.9(1), 90
08/15/2011
DOI: 10.1186/1477-7819-9-90
PMCID: PMC3170616
PMID: 21843361
url
https://doi.org/10.1186/1477-7819-9-90View
Published (Version of record) Open Access

Abstract

For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND) is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus®, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus® will decrease operative time and reduce post-operative complications. Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study. Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups. In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.
 Breast Neoplasms - surgery Ultrasonic Surgical Procedures - instrumentation Breast Neoplasms - secondary Follow-Up Studies Humans Middle Aged Treatment Outcome Lymphatic Metastasis Equipment Design Lymph Node Excision - instrumentation Time Factors Axilla Ultrasonics - instrumentation Female Retrospective Studies Ultrasonic Surgical Procedures - utilization

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