The Clinical Value Of Preserving Intercostobrachial Nerve In Modified Radical Mastectomy

ObjectiveTo investigate the clinical value of preserving the intercostobrachial nerve (ICBN) during modified radical mastectomy.Materials and methods82 patients with modified radical mastectomy in Department of General Surgery of the Second Affiliated Hospital, Medical College of Shantou University from February 2009 to August 2010, were analyzed. In 39 cases, the operation was performed by preserving ICBN, and the ICBN was not preserved in 43 cases. The general situation of operation (time, bleeding volume, number of dissected lymph nodes), postoperative complications, cutaneous sensory disturbance in axillary fossa and upper arm, pain in upper arm were all examined in 1 month, 3 month, 6 month after the surgery respectively. As well as the partial recurrence, metastasis, etc in the two groups were compared. Hamilton anxiety scale (HAMA) was also used to investigate the status of psychological anxiety 1 week and 1 month after operation respectively.ResultsNo difference in the operation time, bleeding volume, number of dissected lymph nodes, and postoperative complications, postoperative local recurrence and metastasis were seen between the two groups (P>0.05). While the morbidity of axillary fossa and upper arm cutaneous sensory disturbance, the incidence of pain were significantly different between the two groups in 1 month, 3 month, 6 month after the surgery respectively(P<0.05). The scores of HAMA at 1 week and 1 month after operation were obviously lower in the preserved group (14.38±6.13,18.95±6.33) than in the excised group(11.56±5.16,14.49±6.40) (P>0.05).ConclusionsPreserving ICBN during modified radical mastectomy dose not affect the effect of axillary lymph node dissection, not to increase the difficulty of the operation and postoperative complications, postoperative local recurrence and metastasis. Preserving ICBN may significantly decrease the morbidity of postoperative cutaneous sensory disturbance on axillary fossa and upper arm, and the incidence of postoperative in axillary lymph node dissection of Modified Radical Mastectomy. Meanwhile, It benefits a lot for the psychological health recovery, so as to improve the quality of life of the patients.