Fan Yu-Chen, Li Lin, Meng Xiang-Chao
Department of General Surgery, The Third Central Hospital of Tianjin, Tianjin, China.
Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China.
Ann Med Surg (Lond). 2025 May 21;87(6):3707-3714. doi: 10.1097/MS9.0000000000002915. eCollection 2025 Jun.
The axillary reverse mapping (ARM) technique has recently been developed to prevent lymphedema by preserving upper extremity lymphatic drainage. In this article, we evaluated the quality of life and oncologic outcomes of ARM used in patients with breast cancer.
PubMed, Embase, and other databases were searched for relevant articles published between 2013 and 2022. Randomized clinical trials were identified and included in the meta-analysis. The evaluated endpoints included lymphedema, the number of retrieved lymph nodes (LNs), the number of patients with positive LNs, and shoulder restriction. A meta-analysis was performed using RevMan 5.3 software. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to analyze dichotomous data.
Seven studies involving 1,820 patients were included for the meta-analysis, which revealed that ARM was associated with a reduced incidence of lymphedema (OR, 0.30; 95% CI, 0.16-0.58; = 0.0003). There were no significant differences in the number of retrieved LNs, the number of patients with positive LNs, and shoulder restriction between the two groups.
The ARM procedure achieved comparable success with a better quality of life and acceptable safe oncologic outcomes for patients with breast cancer. Future multicenter randomized controlled trials are needed to further evaluate the efficacy and safety of ARM.
腋窝反向映射（ARM）技术最近已被开发出来，通过保留上肢淋巴引流来预防淋巴水肿。在本文中，我们评估了乳腺癌患者使用ARM后的生活质量和肿瘤学结局。
检索PubMed、Embase和其他数据库，查找2013年至2022年期间发表的相关文章。确定随机临床试验并纳入荟萃分析。评估的终点包括淋巴水肿、回收淋巴结（LN）的数量、LN阳性患者的数量和肩部活动受限情况。使用RevMan 5.3软件进行荟萃分析。采用比值比（OR）及95%置信区间（CI）分析二分数据。
七项涉及1820例患者的研究纳入荟萃分析，结果显示ARM与淋巴水肿发生率降低相关（OR，0.30；95%CI，0.16 - 0.58；P = 0.0003）。两组在回收LN的数量、LN阳性患者的数量和肩部活动受限方面无显著差异。
对于乳腺癌患者，ARM手术取得了相当的成功，生活质量更好，肿瘤学结局安全可接受。未来需要多中心随机对照试验进一步评估ARM的疗效和安全性。
