The Effect Of Intercostal Arm Nerve Preservation On Upper Arm Of Affected Limb During Axillary Lymph Node Dissection For Breast Cancer:A Meta-analysis

Objective:This meta-analysis study was conducted by comparing the effects of preserving intercostal arm nerves and non-preserving intercostal arm nerves on patients with breast cancer after axillary lymph node dissection on patients with postoperative upper arm paind and dullness and numbness and operation time and number of lymph nodes,to assess the need to preserve intercostal arm nerves during axillary lymph node dissection in breast cancerMethods:In this study,all relevant literatures including postoperative complications after axillary lymph node dissection or ICBN removal were included in the database of Pubmed,Embase and The Cochrane Library.The retrieval period was from the establishment of the database to November 2019.Literature was independently screened based on uniform inclusion and exclusion criteria,data was extracted and recorded using a unified data extraction table,and the quality of the articles covered was assessed using the Cochrane bias risk assessment tool.Meta-analysis was performed using Review Manager 5.3 software,and calculation was performed using a random effect model or a fixed effect model.Results:This study included 8 related studies.The correction results are as follows:There is a significant difference in the incidence of pain(OR=0.5,95%CI,0.29—0.85,P=0.01),dullness(OR=0.40,95%CI,0.22—0.72,P=0.002),and numbness(OR=0.56,95%CI,0.31—1.00,P=0.05)in the upper arm of the affected side compared with the removal of ICBN during the axillary lymph node removal during breast cancer surgery.Axillary lymph node dissection for breast cancer patients in the ICBN-preserving group compared with the non-preserving intercostal arm nerve group.There was no significant difference in the number of postoperative lymph nodes(OR=0.65,95%CI 为-0.80—2.10,P=0.38>0.05)and operation time(OR=1.26,95%CI 为-3.71—6.23,P=0.62)between the two groups.Conclusion:Preserving ICBN during axillary lymph node dissection for breast cancer patients can reduce postoperative upper arm pain,dullness,and numbness complications.Axillary lymph node dissection for breast cancer patients to preserve ICBN and avoid injury will not increase the operation time,and the risk of postoperative bleeding.