[Efficacy of ANTISTAX in treatment of postmastectomic oedema of the upper limb].

Analysed herein are the results of two-year treatment with Antistax of 50 female patients presenting with early stages of upper limb lymphedema (the 'preclinical' stage of 'transient' oedemas, mild-oedema stage). The control group consisted of patients who due to various circumstances received no regular treatment with agents decreasing limb oedema, including diuretics. The obtained results demonstrated undoubted efficacy of Antistax administered at early stages of postmastectomic lymphedema. Preventive administration of the agent makes it possible to delay and in the majority of cases to also prevent the development of lymphedema. Administration of Antistax in a combination with physiotherapeutic treatment makes it possible both in the first and second stages of the disease to preserve the cosmetic and functional state of the upper limb.

[Lymphoscintigraphy in the diagnosis and prognosis of post-mastectomy edema of the extremities]. / Limfostsintigrafiia v diagnostike i prognozirovanii postmastéktomicheskogo oteka konechnosti.

Dynamic lymphoscintigraphy provides adequate means for in vivo contrast-enhanced examination of functional lymph collectors in the extremeties which in turn offers best advantage in diagnosing post-mastectomy edema of the arms. A comparative study was concerned with lymph flow in healthy subjects, breast cancer patients and those with post-mastectomy edema and without it after complete course of treatment. A group of risk for edema was formed.

[Characteristics of lymph flow in patients with post-mastectomy syndrome, based on lymphoscintigraphy data]. / Kharakteristika limfotoka u bol'nykh s postmastéktomichekim sindromom po dannym limfostsintigrafii.

Lymphoscintigraphy allows to get intravital contrast of functionally valuable lymph collectors of the extremity. A comparative analysis was made of the state of lymph flow in healthy subjects, in patients with breast cancer and in patients with the completed cycle of treatment of breast cancer having postmastectomy edema and without it. The investigation was performed in 280 extremities. Principal variants of the normal lymph flow (collector, diffuse, nodal) were marked out. Possible compensatory mechanisms ameliorating the draining function of the extremity were followed in patients with blocked lymph outflow. Programs of prognosis and treatment of patients with preclinical stage of postmastectomy edema are outlined.

[Saving the musculus pectoralis minor in radical mastectomy]. / K voprosu ostavleniia maloi grudnoi myshtsy pri radikal'noi mastéktomii.

Eighty-five patients were surgically treated for postmastectomy edema of the upper extremity. In 20 of them, phlebolysis of the subclavian vein was performed. It was established that the vein was most often compressed by a long stump of the small pectoral muscle. Surgery and subsequent radiation treatment create unfavorable conditions for the muscle leading to its morphologic restructuring. Classic mastectomy after Halsted-Meier is recommended.

[Surgical tactics in post-mastectomy edema of the arm]. / Khirurgicheskaia taktika pri postmastéktomicheskom oteke konechnosti.

Based on examinations and treatment of 210 patients with postmastectomy edema of the extremity (with operations made on 75 of them) the authors have developed a clinico-surgical classification of the postmastectomy edema with special reference to the character of morphologic alterations of soft tissues which determinates tactics of treatment and choice of surgical methods (LVA, phlebolysis of the subclavian vein, RRO or their combination in different succession). Phlebographic and tonometric examinations are shown to be necessary, their findings being compared for the establishment of indications for phlebolysis for stenosis of the vein resulting from X-ray therapy and long stump of the musculus pectoralis minor in radical mastectomy after Holsted.

[Treatment of postmastectomy edema of the upper extremity using microsurgical technics]. / Lechenie postmastéktomicheskogo oteka verkhnei konechnosti s ispol'zovaniem mikrokhirurgicheskoi tekhniki.

Reconstructive microsurgery carried out in 25 cases of postmastectomy edema of the upper extremity proved to be the most effective and safest in treatment of the said complication. The procedure should be supplemented with phlebolysis of the subclavicular vein (when occlusion of the latter exceeds 50%) or with resection of dermatofascial flap of the brachial area (fibrous stage of lymphostasis). Sequence of stages and the results of the surgical treatment are discussed.