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Complete Endoscopic Axillary Lymph Node Dissection Without Liposuction for Breast Cancer: Initial Experience and Mid-term Outcome

Gomatos, Ilias P. MD*; Filippakis, George MD*; Albanopoulos, Konstantinos MD, PhD*; Zografos, George MD, PhD; Leandros, Emmanuel MD, PhD*; Bramis, John MD, PhD*; Konstadoulakis, Manousos M. MD, PhD*

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: August 2006 - Volume 16 - Issue 4 - p 232-236
Original Articles

Aim To present our initial experience with complete endoscopic axillary lymph node dissection (EALND) in 4 breast cancer patients with respect to feasibility, safety, and clinical outcome.

Patients and Methods Between January 2003 and March 2004, 4 women consented to be treated with lumpectomy followed by complete (level I, II, and III) EALND without liposuction, at the Laparoendoscopic Unit of Athens Medical School. All 4 patients presented with a solitary breast cancer lesion smaller than 2 cm in diameter and a negative clinical and sonographic lymph node status (<1 cm).

Results All the operations were completed endoscopically in less than 70 minutes (44 to 69 min). The axillary lymph node harvest ranged between 12 and 21 nodes. No lymphedema, motor nerve damage, seroma formation, or wound complications were observed. Prolonged hospitalization, owing to persistent lymphorrhoea was required for 1 patient. During a mean follow-up of 21.3 months, 2 patients reported mild hypoesthesia-paresthesia along the upper medial part of the respective arm, whereas no tumor recurrences were documented.

Conclusions Although partial EALND has not been established as the treatment of choice for axillary management, complete EALND seems to be a feasible and effective minimally invasive treatment modality, which could be safely applied in patients with positive sentinel node biopsy, treated in specialized centers.

*Laparoendoscopic Unit

Breast Cancer Unit, 1st Department of Propaedeutic Surgery, Hippocration Hospital of Athens, Athens Medical School, 114 Q. Sofia Avenue, 11527 Athens, Greece

Sources of Support: The study has been sponsored by the Athens University and to the Greek Ministry of Health and Welfare.

Reprints: Manousos M. Konstadoulakis, MD, PhD, Kalvou 24, Old Psichiko, 154 52 Athens, Greece (e-mail:;

Received for publication May 9, 2005; accepted March 6, 2006

© 2006 Lippincott Williams & Wilkins, Inc.