Axillary lymphadenectomy. A prospective, randomized trial of 13 factors influencing drainage, including early or delayed arm mobilization
J. A. Petrek, M. M. Peters, S. Nori, C. Knauer, D. W. Kinne and A. Rogatko
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.
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).
