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Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education

Objective: To determine if patients with a prior history of axillary lymph node dissection (ALND) secondary to breast cancer surgery and other procedures are at an increased risk of postoperative complications including lymphedema and infection following elective upper extremity surgery. Furthermore...

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Autores principales: Awan, Muhammad Usman, Schwartz, Gary, Shifchik, Anastassia, Harmon, Skylar, Malisetyan, Tatevik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420452/
https://www.ncbi.nlm.nih.gov/pubmed/36051709
http://dx.doi.org/10.7759/cureus.27461
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author Awan, Muhammad Usman
Schwartz, Gary
Shifchik, Anastassia
Harmon, Skylar
Malisetyan, Tatevik
author_facet Awan, Muhammad Usman
Schwartz, Gary
Shifchik, Anastassia
Harmon, Skylar
Malisetyan, Tatevik
author_sort Awan, Muhammad Usman
collection PubMed
description Objective: To determine if patients with a prior history of axillary lymph node dissection (ALND) secondary to breast cancer surgery and other procedures are at an increased risk of postoperative complications including lymphedema and infection following elective upper extremity surgery. Furthermore, the study aimed to evaluate the extent of patient education regarding lymphedema as a possible complication of upper extremity surgery. Methods: A review of 312 patients presenting to the clinic with upper extremity pathologies was performed of which 15 patients had a history of surgeries secondary to breast cancer and 297 had no prior history of breast cancer. Nine out of 15 patients with prior breast procedures and 66 out of 297 patients with no such history underwent elective hand surgeries, with 22 out of the 75 patients having a history of ALND. Incidences of postoperative complications including lymphedema and infection were recorded. Afterward, a survey inquiring about patient education was conducted to assess whether the patients were educated regarding lymphedema and if so, when and from whom they received the counseling. Results: No patients with a prior history of ALND secondary to breast cancer or other surgeries developed a postoperative infection or onset of lymphedema, and no patients with preoperative lymphedema had any worsening of lymphedema or infection postoperatively. The survey conducted afterward revealed that 61% of the patients with a prior history of breast cancer-related procedures including lymph node dissection were never counseled regarding lymphedema as a possible complication of hand surgery. Furthermore, 75% of the survey participants wished they were given more information about possible causes and complications of, and ways to prevent or minimize the possibility of lymphedema developing postoperatively. Conclusion: Prior history of ALND did not make patients more susceptible to postoperative complications, thus a history of isolated ALND or breast cancer surgery including ALND should not preclude elective hand surgical procedures from being performed ipsilaterally. Additionally, improvements in the degree of patient counseling regarding postoperative complications following hand surgery are needed as increased patient education is shown to be associated with a lower rate of complications and faster recovery times.
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spelling pubmed-94204522022-08-31 Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education Awan, Muhammad Usman Schwartz, Gary Shifchik, Anastassia Harmon, Skylar Malisetyan, Tatevik Cureus Oncology Objective: To determine if patients with a prior history of axillary lymph node dissection (ALND) secondary to breast cancer surgery and other procedures are at an increased risk of postoperative complications including lymphedema and infection following elective upper extremity surgery. Furthermore, the study aimed to evaluate the extent of patient education regarding lymphedema as a possible complication of upper extremity surgery. Methods: A review of 312 patients presenting to the clinic with upper extremity pathologies was performed of which 15 patients had a history of surgeries secondary to breast cancer and 297 had no prior history of breast cancer. Nine out of 15 patients with prior breast procedures and 66 out of 297 patients with no such history underwent elective hand surgeries, with 22 out of the 75 patients having a history of ALND. Incidences of postoperative complications including lymphedema and infection were recorded. Afterward, a survey inquiring about patient education was conducted to assess whether the patients were educated regarding lymphedema and if so, when and from whom they received the counseling. Results: No patients with a prior history of ALND secondary to breast cancer or other surgeries developed a postoperative infection or onset of lymphedema, and no patients with preoperative lymphedema had any worsening of lymphedema or infection postoperatively. The survey conducted afterward revealed that 61% of the patients with a prior history of breast cancer-related procedures including lymph node dissection were never counseled regarding lymphedema as a possible complication of hand surgery. Furthermore, 75% of the survey participants wished they were given more information about possible causes and complications of, and ways to prevent or minimize the possibility of lymphedema developing postoperatively. Conclusion: Prior history of ALND did not make patients more susceptible to postoperative complications, thus a history of isolated ALND or breast cancer surgery including ALND should not preclude elective hand surgical procedures from being performed ipsilaterally. Additionally, improvements in the degree of patient counseling regarding postoperative complications following hand surgery are needed as increased patient education is shown to be associated with a lower rate of complications and faster recovery times. Cureus 2022-07-29 /pmc/articles/PMC9420452/ /pubmed/36051709 http://dx.doi.org/10.7759/cureus.27461 Text en Copyright © 2022, Awan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Oncology
Awan, Muhammad Usman
Schwartz, Gary
Shifchik, Anastassia
Harmon, Skylar
Malisetyan, Tatevik
Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education
title Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education
title_full Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education
title_fullStr Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education
title_full_unstemmed Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education
title_short Elective Hand Surgery in Patients With History of Axillary Node Dissection: Risks and Patient Education
title_sort elective hand surgery in patients with history of axillary node dissection: risks and patient education
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420452/
https://www.ncbi.nlm.nih.gov/pubmed/36051709
http://dx.doi.org/10.7759/cureus.27461
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