33rd Annual Scientific Meeting proceedings

Intra-operative axillary lymph node localization and lymphadenectomy is historically deemed challenging and time-consuming, with reports of intra-operative mapping techniques and/or video-assisted dissection being required due to its deep location. The objective of this study was to describe a consistent surgical approach for open axillary lymph node extirpation in a cadaver, and to retrospectively review outcome and complications when performed in dogs diagnosed with local malignant tumours. 

The axillary lymph nodes were removed from a cadaver to illustrate anatomical landmarks and highlight the surgical approach. No special instrumentation was necessary. Medical records of dog undergoing axillary lymph node removal were reviewed. Data retrieved included breed, sex, age, body weight; surgeon; anatomic location primary tumour; pre-operative staging; lymph node removal left vs. right; overall surgical time; histopathology of the lymph node and primary tumour; intra- and post-operative complications; and length of follow-up. 

A total of 23 axillary lymph nodes in 22 patients were removed using the described technique: 10 left and 13 right. The mean body weight was 22.8kg (range 5.3 - 49.8kg). The lymph nodes were identified and removed in all cases through a separate (n=16) or same incision (n=6). No major complications were encountered. 

The anatomical location of the axillary lymph node was similar in all cases deep to the latissimus dorsi muscle and cranial, lateral and dorsal to the costochondral junction of the first rib. The described approach proved consistently successful to expose it efficiently. Axillary lymph node extirpation can be performed successfully without additional intra-operative guidance.