Nadkarni Mandar S, Rangole Ashvin K, Sharma Ruppal K, Hawaldar Rohini V, Parmar Vani V, Badwe Rajendra A
Tata Memorial Hospital, Department of Surgical Oncology, Mumbai, Maharashtra, India.
ANZ J Surg. 2007 May;77(5):385-9. doi: 10.1111/j.1445-2197.2007.04067.x.
The aim of this study was to evaluate the influence of surgical technique in the form of electrocautery and suction drains on seroma formation following surgery for breast cancer. A prospective randomized study was carried out. One hundred and sixty patients with breast cancer who underwent surgery were allocated to four arms using a 2 x 2 factorial design. This method enabled us to evaluate the independent effect of two different causative factors on the incidence of postoperative seroma formation using a single dataset with limited numbers. The main outcome measure was postoperative seroma formation defined as a postoperative axillary collection requiring more than one aspiration after removal of the drain. The incidence of seroma in our institution is 90%. Incidence of postoperative seroma was 88.3% if electrocautery was used, which reduced to 82.2% if surgery was carried out using scissors for dissection and ligatures for haemostasis (P = 0.358). There was no influence on the incidence of seroma formation whether suction drain (84.6%) or corrugated drains (86.1%) were used (P = 0.822). The use of electrocautery in axillary dissection does not adversely affect postoperative seroma formation after surgery for breast cancer. The use of different drainage techniques has no bearing on the postoperative seroma formation. The surgical technique has no influence on the rate of seroma formation after surgery for breast cancer.
本研究的目的是评估以电灼术和引流管形式存在的手术技术对乳腺癌手术后血清肿形成的影响。开展了一项前瞻性随机研究。160例接受手术的乳腺癌患者采用2×2析因设计被分配到四个组。这种方法使我们能够使用数量有限的单一数据集评估两种不同致病因素对术后血清肿形成发生率的独立影响。主要结局指标是术后血清肿形成，定义为拔除引流管后腋窝积液需要不止一次抽吸。我们机构血清肿的发生率为90%。如果使用电灼术，术后血清肿的发生率为88.3%，如果手术使用剪刀进行解剖并用结扎线止血，该发生率降至82.2%（P = 0.358）。无论使用负压引流管（84.6%）还是波纹引流管（86.1%），对血清肿形成的发生率均无影响（P = 0.822）。在乳腺癌手术后的腋窝清扫中使用电灼术不会对术后血清肿形成产生不利影响。使用不同的引流技术与术后血清肿形成无关。手术技术对乳腺癌手术后血清肿的形成率没有影响。
