Department of Surgery, Second University of Naples, Piazza Miraglia 1, 80138 Naples, Italy.
Am J Surg. 2012 Jun;203(6):708-14. doi: 10.1016/j.amjsurg.2011.06.051. Epub 2011 Dec 6.
Seroma formation after axillary dissection remains the most common early sequel to breast cancer surgery. Different surgical approaches have been performed to reduce seroma collection. Therefore, we aimed to assess the outcome of patients operated on using an ultrasound scalpel according to a standardized operative technique before accepting it as a routine procedure.
A randomized controlled trial was designed to compare the outcome of patients undergoing breast surgery and axillary dissection using either standard scalpel blades, scissors, ligations, and electrocautery or the ultrasound scalpel only. Each arm of the trial consisted of 30 patients.
A statistically significant benefit in terms of axillary and chest wall drainage volume, the number of axilla seromas, intraoperative bleeding, and hospitalization stay was recorded in the harmonic scalpel group. No significant differences were found between the 2 groups in terms of operative time. Finally, no postoperative hematoma, wound infections, and chest wall seroma were observed.
The use of the harmonic scalpel was shown to reduce the magnitude of seromas in axilla and hospitalization stay. The harmonic scalpel can be used alone in axillary dissection with a safe and effective hemostasis. Our results must be confirmed by larger series.
腋窝清扫术后的血清肿形成仍然是乳腺癌手术后最常见的早期并发症。已经采用了不同的手术方法来减少血清肿的积聚。因此，我们旨在评估使用超声刀按照标准化手术技术进行手术的患者的结果，然后再将其作为常规手术方法。
设计了一项随机对照试验，以比较使用标准手术刀、剪刀、结扎和电灼或仅使用超声刀进行乳房手术和腋窝清扫术的患者的结果。试验的每个臂包括 30 名患者。
在超声刀组中，在腋窝和胸壁引流量、腋窝血清肿数量、术中出血和住院时间方面记录到了统计学上的显著获益。两组在手术时间方面没有发现显著差异。最后，没有发现术后血肿、伤口感染和胸壁血清肿。
使用超声刀可减少腋窝和住院时间的血清肿量。超声刀可单独用于腋窝清扫术，具有安全有效的止血效果。我们的结果必须通过更大的系列来证实。
