Petrek J A, Peters M M, Nori S, Knauer C, Kinne D W, Rogatko A
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.
Arch Surg. 1990 Mar;125(3):378-82. doi: 10.1001/archsurg.1990.01410150100018.
Greater amount and duration of postoperative wound drainage after lymphadenectomy impede healing. We evaluated the influence of early vs delayed initiation of shoulder mobilization on postoperative drainage. Fifty-seven women with clinical stage I or II breast cancer were randomized to either early (postoperative day 2) or delayed (postoperative day 5) shoulder motion. Early vs delayed time of exercise initiation had no effect on total amount or duration of drainage, either as an inpatient or outpatient. The two groups were determined to be homogeneous as to age, breast size, weight, height, obesity, previous biopsy, excision of pectoralis minor, excision of thoracodorsal complex, level of axillary dissection, total number of lymph nodes, number of positive lymph nodes, lymphatic vessel invasion (with negative lymph nodes), and whether the dominant hand was on the side operated on. The two factors predicting greater drainage were large numbers of positive lymph nodes and no previous surgical biopsy (as in one-step procedure).
淋巴结清扫术后伤口引流的量和持续时间增加会妨碍愈合。我们评估了早期与延迟开始肩部活动对术后引流的影响。57例临床I期或II期乳腺癌女性被随机分为早期（术后第2天）或延迟（术后第5天）开始肩部活动。无论是住院患者还是门诊患者，早期与延迟开始运动对引流总量或持续时间均无影响。两组在年龄、乳房大小、体重、身高、肥胖情况、既往活检、胸小肌切除、胸背复合体切除、腋窝清扫水平、淋巴结总数、阳性淋巴结数、淋巴管侵犯（阴性淋巴结情况）以及优势手是否在手术侧等方面均被确定为同质。预测引流较多的两个因素是大量阳性淋巴结和既往无手术活检（如一步法手术）。
