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The Risk of Lymphedema in Elective Hand Surgery After Axillary Lymph Node Sampling: A Prospective, Cohort Study
Susan M Odum1, Casey Sabbag2, Warren Hammert3
1Atrium Health, Charlotte, NC, USA.
Hand (New York, N.Y.)
|March 28, 2026
Summary
Elective upper-extremity surgery in breast cancer patients with lymph node sampling is safe with or without a tourniquet. This study found a low risk of lymphedema and complications, regardless of tourniquet use.
Area of Science:
- Oncology
- Lymphedema Research
- Surgical Complications
Background:
- Assessing risks for patients with a history of breast cancer and prior axillary lymph node sampling.
- Evaluating lymphedema and surgical complication rates in elective upper-extremity procedures.
Purpose of the Study:
- To evaluate the risk of lymphedema and perioperative complications.
- Compare outcomes with and without tourniquet use in patients undergoing elective upper-extremity surgery post-breast cancer treatment.
Main Methods:
- Prospective cohort study with 78 patients meeting inclusion criteria.
- Volumetric limb measurements pre- and post-surgery; complication recording.
- Follow-up at 2-week to 12-month intervals; comparison between tourniquet and no-tourniquet groups.
Main Results:
- Three cases of lymphedema observed within 2 weeks, resolving in one case by 6 weeks.
- Low incidence of other complications, including pin displacement, hematoma, and hand stiffness.
- High patient satisfaction in both tourniquet and no-tourniquet groups, with no statistically significant difference.
Conclusions:
- Elective upper-extremity surgery post-breast cancer lymph node sampling is safe.
- Tourniquet use does not significantly alter complication rates or lymphedema risk.
- Low overall complication rates, including minimal lymphedema exacerbation, support surgical safety.
