Ridgway P F, Collins A M, McCready D R
Department of Surgery, Trinity College Dublin at the Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Surg Radiol Anat. 2011 Mar;33(2):147-9. doi: 10.1007/s00276-010-0724-3. Epub 2010 Sep 2.
When Carl Langer described the aberrant axillary arch in 1846 its relevance in sentinel node biopsy (SNB) surgery could not have been contemplated. The authors define an incidence and elucidate relevance of the arch in SNB of the axilla.
A review of a database for breast and melanoma axillary SNB was carried out. The sample was 1 year at Princess Margaret Hospital, Toronto.
Of 319 axillary SNB, 3 (0.9%) had axillary arches noted. Two were in the melanoma group (n = 59) and one in the breast (n = 260). Interestingly one arch case had an ipsilateral 'idiopathic' axillary vein thrombosis as a child.
The authors see no reason to deviate from the practice of division of the arch at the highest level when recognised at SNB. This would abrogate the risk of concealed nodes and possible future neurovascular compression.
1846年卡尔·兰格描述异常腋弓时，不可能预见到其在前哨淋巴结活检（SNB）手术中的相关性。作者确定了该弓在腋窝SNB中的发生率并阐明其相关性。
对乳腺和黑色素瘤腋窝SNB的数据库进行回顾。样本来自多伦多玛格丽特公主医院的1年数据。
在319例腋窝SNB中，有3例（0.9%）发现有腋弓。2例在黑色素瘤组（n = 59），1例在乳腺组（n = 260）。有趣的是，1例弓病例在儿童时期有同侧“特发性”腋静脉血栓形成。
作者认为，在前哨淋巴结活检时识别出腋弓后，没有理由不按照在最高水平切断该弓的做法。这将消除隐匿性淋巴结的风险以及未来可能的神经血管受压风险。
