Repair of Transected Axillary Vein

Axillary node clearance is the part of  operative management for disease control in invasive breast cancer. Axillary  node clearance can be defined as clearing the axillary contents bounded by the axillary skin laterally,latismus dorsi, teres major and subscapularies posterirly,the lower border of the axillary vein superiorly,pectoralis muscles anteriorly and the chest wall medially.
During axillary clearance using sharp dissection, pledgelet dissection and haemostasis with diathermy the lower margin of the axillary vein is exposed. Care should be taken to identify the lower border of the axillary vein.

Case Report
An accidental near complete transection of Axillary vein in left side was happened during axillary node clearance of a patient with breast cancer. During Sharp dissection for axillary vein exposure this unwanted complication was happened.Surgeon initially tried to repair it,but lumen of vein compromised. No blood drained through the repaired vein.Proximal to the anastomotic site become distended but distal to that the vein collapsed. After that surgeon called me for opinion as a vascular surgeon.I examined the anastomotic site and found the complete occlusion of the lumen of axillary vein. Systemic heparinazation done. I cut down the suture and undo the anastomosis. Ragged margin was trimmed and re-anastomosis was done with 5-0 prolene. The blood flow through the vein was re-established.Systemic heparinization continued for 72 hours followed by oral anticoagulants.In postoperative period upper limb was kept elevated. Postoperative period was uneventful . Patient discharged with full recovery.

 The report cover our expeience with the recovery of an accidental near complete transection of axillary vein at a private hospital.