Somers R G, Jablon L K, Kaplan M J, Sandler G L, Rosenblatt N K
Department of Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
Ann Surg. 1992 Feb;215(2):146-9. doi: 10.1097/00000658-199202000-00009.
Closed suction drainage has been used to prevent seroma formation after lumpectomy and axillary node dissection for breast cancer. To study the efficacy of closed suction drains, the authors conducted a prospective randomized study from 1987 to 1990 of 227 axillary dissections. One hundred eight were randomized to a drain group (DG) and 119 to a no drain group (NDG). Drains were removed on the first postoperative day just before patient discharge. Postoperatively, all palpable axillary collections were aspirated on each follow-up visit. The volume aspirated, the number of aspirations, the time to seroma resolution, and all complications were recorded. The mean number of aspirations in the DG was significantly lower than the NDG (2.2 +/- 2.2 versus 3.3 +/- 2.1; p less than or equal to 0.002). Mean volume aspirated in the DG (146.3 +/- 181.1 mL) was less than the NDG (266.1 +/- 247.6 mL; p less than or equal to 0.003), and the time to seroma resolution was decreased in the DG as compared with the NDG (11.5 +/- 10 days versus 18 +/- 10.1 days; p less than or equal to 0.0002). Closed suction drainage after lumpectomy and axillary node dissection is advantageous in decreasing the incidence and degree of seroma formation and need not delay early hospital discharge.
闭式负压引流已被用于预防乳腺癌保乳手术及腋窝淋巴结清扫术后血清肿的形成。为研究闭式负压引流的疗效，作者于1987年至1990年对227例腋窝清扫术进行了一项前瞻性随机研究。108例被随机分为引流组（DG），119例被分为无引流组（NDG）。术后第一天患者出院前拔除引流管。术后，每次随访时对所有可触及的腋窝积液进行抽吸。记录抽吸量、抽吸次数、血清肿消退时间及所有并发症。引流组的平均抽吸次数显著低于无引流组（2.2±2.2比3.3±2.1；p≤0.002）。引流组的平均抽吸量（146.3±181.1 mL）少于无引流组（266.1±247.6 mL；p≤0.003），与无引流组相比，引流组血清肿消退时间缩短（11.5±10天比18±10.1天；p≤0.0002）。保乳手术及腋窝淋巴结清扫术后采用闭式负压引流有利于降低血清肿形成的发生率和程度，且无需延迟早期出院。
