Banerjee D, Williams E V, Ilott J, Monypenny I J, Webster D J
Cardiff Breast Unit, Llandough Hospital, Penarth, UK.
Ann R Coll Surg Engl. 2001 Jul;83(4):268-71.
Whilst sentinel node biopsy is being evaluated for optimising treatment of the axilla, axillary dissection remains the gold standard. Seroma formation, a common sequel to axillary dissection, has been shown to be associated with an increased incidence of wound infection, delayed healing, and lymphoedema. This study was conducted to evaluate the possible contributory role of obesity in axillary drainage following lymphatic dissection.
This study comprised a prospective review of all patients undergoing axillary dissection in conjunction with mastectomy or wide local excision. The total in-patient axillary drainage and the average daily drainage was correlated with various clinical parameters, including obesity, type of surgery, level of axillary dissection and nodal involvement. The body mass index (BMI) was used as a measure of obesity.
During a 6-month period, axillary dissection was performed in 79 women. Nineteen patients were excluded. Patey mastectomy was performed on 33 (55%) and the remaining had breast conservation. The amount or duration of axillary drainage did not correlate with the type of operation, tumour histology, level of axillary dissection or the nodal status. Higher BMI correlated with increased mean daily axillary drainage and total volume drained, whilst in hospital. (Spearman correlation coefficient 0.42; P < 0.01).
Obesity predisposes to increased axillary drainage following nodal clearance.
虽然前哨淋巴结活检正在被评估用于优化腋窝治疗，但腋窝清扫术仍然是金标准。血清肿形成是腋窝清扫术常见的后遗症，已被证明与伤口感染、愈合延迟和淋巴水肿的发生率增加有关。本研究旨在评估肥胖在淋巴结清扫术后腋窝引流中可能的促成作用。
本研究包括对所有接受腋窝清扫术并联合乳房切除术或广泛局部切除术的患者进行前瞻性回顾。住院期间腋窝总引流量和平均每日引流量与各种临床参数相关，包括肥胖、手术类型、腋窝清扫水平和淋巴结受累情况。体重指数（BMI）用作肥胖的衡量指标。
在6个月期间，对79名女性进行了腋窝清扫术。19名患者被排除。33名（55%）患者进行了帕蒂乳房切除术，其余患者进行了保乳手术。腋窝引流的量或持续时间与手术类型、肿瘤组织学、腋窝清扫水平或淋巴结状态无关。较高的BMI与住院期间平均每日腋窝引流量和总引流量增加相关。（斯皮尔曼相关系数0.42；P < 0.01）。
肥胖易导致淋巴结清除术后腋窝引流增加。
