BACKGROUND: Complications of axillary surgery occur due to severance of the intercostobrachial nerve (ICBN). The feasibility and benefit of preserving the ICBN to prevent sensory loss was studied prospectively. METHODS:Sensory symptoms and deficits were documented, and shoulder movement and arm circumference were measured at discharge and 3 months later in 120 patients randomized to either preservation or division of the ICBN. RESULT: Preserving the ICBN was feasible in 39 (65 per cent) of the 60 patients randomized to the preservation group. Preserving the nerve prolonged the procedure by a median of 5 min. No difference in sensory symptoms between the groups was seen at 3 months. At 3 months 53 per cent of patients randomized to ICBN preservation had a sensory deficit compared with 84 per cent of those randomized to ICBN sacrifice (P < or = 0.05). CONCLUSION: Preserving the ICBN reduces the incidence of sensory deficit (but not symptoms) in patients after axillary clearance.
RCT Entities:
BACKGROUND: Complications of axillary surgery occur due to severance of the intercostobrachial nerve (ICBN). The feasibility and benefit of preserving the ICBN to prevent sensory loss was studied prospectively. METHODS: Sensory symptoms and deficits were documented, and shoulder movement and arm circumference were measured at discharge and 3 months later in 120 patients randomized to either preservation or division of the ICBN. RESULT: Preserving the ICBN was feasible in 39 (65 per cent) of the 60 patients randomized to the preservation group. Preserving the nerve prolonged the procedure by a median of 5 min. No difference in sensory symptoms between the groups was seen at 3 months. At 3 months 53 per cent of patients randomized to ICBN preservation had a sensory deficit compared with 84 per cent of those randomized to ICBN sacrifice (P < or = 0.05). CONCLUSION: Preserving the ICBN reduces the incidence of sensory deficit (but not symptoms) in patients after axillary clearance.
Authors: Li Wang; Gordon H Guyatt; Sean A Kennedy; Beatriz Romerosa; Henry Y Kwon; Alka Kaushal; Yaping Chang; Samantha Craigie; Carlos P B de Almeida; Rachel J Couban; Shawn R Parascandalo; Zain Izhar; Susan Reid; James S Khan; Michael McGillion; Jason W Busse Journal: CMAJ Date: 2016-07-11 Impact factor: 8.262
Authors: Brandon Michael Henry; Matthew J Graves; Jakub R Pękala; Beatrice Sanna; Wan Chin Hsieh; R Shane Tubbs; Jerzy A Walocha; Krzysztof A Tomaszewski Journal: Cureus Date: 2017-03-17