Endoscopic axillary dissection: A systematic review of the literature

Objectives: To assess the feasibility, effectiveness and morbidity associated with Endoscopic Axillary Dissection. Methods: All studies published from 1990 until December 2008 in MEDLINE, LILACS, and COCHRANE. These studies were selected by two levels of criteria. Methodological designs, operating parameters, and postoperative follow-up were selected from each publication. Results: We extracted 49 citations and 12 were analyzed. The average age was 54.95 +/- 5.84 years. The surgical time was longer than the open procedure. The average number of extracted nodes exceeded ten. Technical problems and intra-operative complications had a rare occurrence. The recurrence was 0.5% (4/752). Two port metastases were registered. The methodological quality score average was 14.75. Conclusions: This procedure meets the tumor control and staging requirements. It has shown similar results to the traditional procedure in terms of patient recovery, although the available evidence is not methodologically appropriate and does not justify its oncological safety. (C) 2009 Elsevier Ltd. All rights reserved.