Article ; Online: Anatomical variants of the intercostobrachial nerve and its preservation during surgery, a systematic review and meta-analysis.
World journal of surgical oncology
2024 Volume 22, Issue 1, Page(s) 92
Abstract: Background: The anatomic variants of the intercostobrachial nerve (ICBN) represent a potential risk of injuries during surgical procedure such as axillary lymph node dissection and sentinel lymph node biopsy in breast cancer and melanoma patients. The ... ...
| Abstract | Background: The anatomic variants of the intercostobrachial nerve (ICBN) represent a potential risk of injuries during surgical procedure such as axillary lymph node dissection and sentinel lymph node biopsy in breast cancer and melanoma patients. The aim of this systematic review and meta-analysis was to investigate the different origins and branching patterns of the intercostobrachial nerve also providing an analysis of the prevalence, through the analysis of the literature available up to September 2023. Materials and methods: The protocol for this study was registered on PROSPERO (ID: CRD42023447932), an international prospective database for reviews. The PRISMA guideline was respected throughout the meta-analysis. A systematic literature search was performed using PubMed, Scopus and Web of Science. A search was performed in grey literature through google. Results: We included a total of 23 articles (1,883 patients). The prevalence of the ICBN in the axillae was 98.94%. No significant differences in prevalence were observed during the analysis of geographic subgroups or by study type (cadaveric dissections and in intraoperative dissections). Only five studies of the 23 studies reported prevalence of less than 100%. Overall, the PPE was 99.2% with 95% Cis of 98.5% and 99.7%. As expected from the near constant variance estimates, the heterogeneity was low, I Conclusions: The prevalence of ICBN variants was very high. The dissection of the ICBN during axillary lymph-node harvesting, increases the risk of sensory disturbance. The preservation of the ICBN does not modify the oncological radicality in axillary dissection for patients with cutaneous metastatic melanoma or breast cancer. Therefore, we recommend to operate on these patients in high volume center to reduce post-procedural pain and paresthesia associated with a lack of ICBN variants recognition. |
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| MeSH term(s) | Humans ; Female ; Melanoma/surgery ; Intercostal Nerves/pathology ; Intercostal Nerves/surgery ; Lymph Node Excision/methods ; Sentinel Lymph Node Biopsy ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Axilla/pathology ; Cadaver |
| Language | English |
| Publishing date | 2024-04-11 |
| Publishing country | England |
| Document type | Meta-Analysis ; Systematic Review ; Journal Article ; Review |
| ZDB-ID | 2118383-1 |
| ISSN | 1477-7819 ; 1477-7819 |
| ISSN (online) | 1477-7819 |
| ISSN | 1477-7819 |
| DOI | 10.1186/s12957-024-03374-w |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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