[Radical mastectomy technics]

Abstract

The authors elaborated a new approach to radical mastectomy which, combined with nonoperative measures makes it possible to prevent the development of postmastectomy-induced edema by means of a lympho-venous anastomosis (LVA). The choice of the level of LVA formation and their number is substantiated. With due regard for the conditions named, the cubital fossa and the lower third of the upper arm on the anterointernal surface is the most rational zone. To accelerate lymph drainage through the collaterals and reduce lymph loss, goal-oriented ligation of the lymph vessels which are divided during mastectomy is additionally carried out; this is successfully done when they have been stained. As a result, wound lymphorrhea ceases practically at days 4 to 5.