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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
BONILLA-SEPULVEDA, Oscar Alejandro. Langer’s axillary arch: case series and literature review. rev. colomb. cir. [online]. 2021, vol.36, n.2, pp.268-274. Epub June 06, 2021. ISSN 2011-7582. https://doi.org/10.30944/20117582.646.
Introduction.
Langer’s arch is an infrequent entity, the prevalence of which depends on the surgical technique used and is usually not associated with symptoms of vascular or neuronal compression. The objective of this study was to describe the clinical and morphological characteristics, and the proportion of symptoms of neurovascular compression of Langer’s arch, in women with breast cancer who underwent axillary surgery.
Methods.
Descriptive study of Langer’s arch in women with breast cancer, who underwent axillary surgery in the personal registry of a surgeon, in Medellín, Colombia, between January 1, 2017 and August 15, 2020. Clinical, morphological and clinical characteristics were evaluated for symptoms of neurovascular compression. Categorical variables were grouped according to their frequency as percentages, and the median and interquartile range were calculated for continuous variables.
Results.
Between January 1, 2017 and August 15, 2020, 725 axillary surgeries, 479 sentinel node biopsies, and 246 lymphadenectomies were performed, finding 17 cases of Langer’s arch, for a frequency of 2.3%. It was more frequently found in the course of lymphadenectomy (n= 11; 64.7%). In 15 (88.2%) cases there was a risk of lymph node concealment and in 14 (82.3%) it generated surgical difficulty. There were no cases with symptoms of vascular or neuronal compression. In no case was the pre-surgical imaging diagnosis made. The predominant surgical approach was section, in 88.2%, without presenting associated surgical complications.
Discussion.
Knowledge of the axillary arch as an anatomical variant of the axilla is important for the surgeon, which can hide the lymph nodes or make axillary dissection difficult, so the most commonly used approach is to cut it.
Keywords : axilla; muscle; sentinel lymph node biopsy; lymph node excision; breast neoplasms; Langer.