Hasan Karanlik1, Berkay Kılıç1, Ilknur Yıldırım2, Süleyman Bademler1, Ilker Ozgur3, Burak Ilhan4, Semen Onder5. 1. Department of Surgery, Institute of Oncology, Istanbul University, Istanbul, Turkey. 2. Institute of Oncology, Department of Anesthesiology, Istanbul University, Istanbul, Turkey. 3. Department of Surgery, Acibadem International Hospital, Istanbul, Turkey. 4. Department of Surgery, Istanbul University School of Medicine, Istanbul, Turkey. 5. Department of Pathology, Institute of Oncology, Istanbul University, Istanbul, Turkey.
Abstract
INTRODUCTION: We report the feasibility and safety of local anesthesia (LA) in patients having breast-conserving surgery (BCS). METHODS: 37 patients with American Society of Anesthesiologists (ASA) score of 4 having BCS under LA and 54 age-matched subjects with ASA score of 3-4 having BCS under general anesthesia (GA) were included. Patients were retrospectively evaluated for the follow-up duration, duration of surgery, postoperative satisfaction scores (1-10), complication and survival time for locoregional recurrence and overall survival rates. RESULTS: The mean follow-up duration was 55.09 ± 13.49 months (range 38-104) in GA group, and 58.7 ± 15.5 months (range 20-99) in LA group. There was a significant difference in the duration of surgery (p < 0.001). In the LA group, 5 patients (13.5%) had minor complications including seroma, wound infection or hematoma, whereas 6 patients (11.1%) had minor complications in the GA group (p > 0.05). The re-excision rate due to positive tumor margins was 5.4% (2 patients) in the LA group and 5.5% in the GA group, respectively. The locoregional recurrence-free survival and overall survival rate was not different between 2 groups (p = 0.192, p = 0.93). CONCLUSION: BCS under LA seemed to be effective and safe in selected high-risk elderly patients.
INTRODUCTION: We report the feasibility and safety of local anesthesia (LA) in patients having breast-conserving surgery (BCS). METHODS: 37 patients with American Society of Anesthesiologists (ASA) score of 4 having BCS under LA and 54 age-matched subjects with ASA score of 3-4 having BCS under general anesthesia (GA) were included. Patients were retrospectively evaluated for the follow-up duration, duration of surgery, postoperative satisfaction scores (1-10), complication and survival time for locoregional recurrence and overall survival rates. RESULTS: The mean follow-up duration was 55.09 ± 13.49 months (range 38-104) in GA group, and 58.7 ± 15.5 months (range 20-99) in LA group. There was a significant difference in the duration of surgery (p < 0.001). In the LA group, 5 patients (13.5%) had minor complications including seroma, wound infection or hematoma, whereas 6 patients (11.1%) had minor complications in the GA group (p > 0.05). The re-excision rate due to positive tumor margins was 5.4% (2 patients) in the LA group and 5.5% in the GA group, respectively. The locoregional recurrence-free survival and overall survival rate was not different between 2 groups (p = 0.192, p = 0.93). CONCLUSION: BCS under LA seemed to be effective and safe in selected high-risk elderly patients.
Entities:
Keywords:
Breast cancer; Breast-conserving surgery; General anesthesia; Local anesthesia; Lymph nodes; Safety; Surgery
Authors: J T Moller; P Cluitmans; L S Rasmussen; P Houx; H Rasmussen; J Canet; P Rabbitt; J Jolles; K Larsen; C D Hanning; O Langeron; T Johnson; P M Lauven; P A Kristensen; A Biedler; H van Beem; O Fraidakis; J H Silverstein; J E Beneken; J S Gravenstein Journal: Lancet Date: 1998-03-21 Impact factor: 79.321