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在乳腺癌腋窝淋巴结清扫术后使用纤维蛋白胶是否可以预防血清肿的形成?一项 159 例患者的前瞻性随机试验。

Does the use of fibrin glue prevent seroma formation after axillary lymphadenectomy for breast cancer? A prospective randomized trial in 159 patients.

机构信息

Division of General and Oncological Surgery, Department of Oncology, University of Palermo, Palermo, Italy.

出版信息

J Surg Oncol. 2010 Jun 1;101(7):600-3. doi: 10.1002/jso.21531.

Abstract

BACKGROUND

Seroma formation frequently occurs in patients who have undergone axillary lymphadenectomy. The aim of the study was to evaluate the effect of fibrin glue in the prevention of seroma formation after axillary lymphadenectomy.

MATERIALS AND METHODS

Hundred fifty-nine breast cancer patients about to undergo quadrantectomy or mastectomy plus axillary lymphadenectomy were enrolled in the study and randomized into two groups. Fibrin glue spray applied to the axillary fossa plus placement of closed suction drainage were used in 80 patients (group A); placement of closed suction drainage was only used in 79 patients (group B).

RESULTS

Group A patients showed a slight advantage with regard to the mean duration of axillary drainage placement (4.5 +/- 1.3 days in group A vs. 5.1 +/- 1.6 days in group B) and number of seroma aspirations (6.3 +/- 1.1 in group A vs. 6.7 +/- 1.2 in group B). No statistically significant differences were observed between the two groups of patients regarding the mean volume of total axillary drainage and of total seroma volume.

CONCLUSIONS

The use of fibrin glue does not prevent seroma formation and does not reduce seroma magnitude and duration. The costs of the product involved do not justify its routine use in patients undergoing axillary dissection.

摘要

背景

腋窝淋巴结清扫术后常发生血清肿。本研究旨在评估纤维蛋白胶在预防腋窝淋巴结清扫术后血清肿形成中的作用。

材料与方法

159 例拟行象限切除术或乳房切除术加腋窝淋巴结清扫术的乳腺癌患者被纳入研究并随机分为两组。80 例患者(A 组)应用纤维蛋白胶喷洒腋窝加闭式引流;79 例患者(B 组)仅采用闭式引流。

结果

A 组患者腋窝引流放置时间(A 组 4.5±1.3 天,B 组 5.1±1.6 天)和血清肿抽吸次数(A 组 6.3±1.1,B 组 6.7±1.2)略占优势。两组患者的总腋窝引流和总血清肿量无统计学差异。

结论

纤维蛋白胶的使用并不能预防血清肿的形成,也不能减少血清肿的程度和持续时间。该产品的使用成本使其不能常规用于接受腋窝清扫的患者。

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