Oxford University Clinical Academic Graduate School, The John Radcliffe Hospital, Oxford OX3 9DU, UK.
Surg Oncol. 2012 Dec;21(4):247-51. doi: 10.1016/j.suronc.2012.05.002. Epub 2012 Jun 12.
To determine the evidence-based optimal strategy for management of drains following axillary dissection.
Despite randomised control trials addressing the issue over the past 20-30 years, there is no widely accepted consensus as to when drains should be removed post axillary dissection.
We searched the electronic databases Medline, Embase, Cinahl, Cochrane Library of Systematic Reviews and Web of Science Citation Index. References within identified studies were also searched. Studies were independently identified and data extracted according to a pre-determined proforma based on the Cochrane Collaboration data extraction template by two independent researchers. Validity was determined according to a published standard. Discrepancies were corrected by consensus.
There was no difference in infection rates between early and late drain removal, hospital stay was reduced when drains were removed earlier, and higher total volume drainage prior to drain removal predicted subsequent seroma formation. The optimal timing of drain removal post axillary dissection could not be determined from the literature.
Optimal timing of drain removal following axillary dissection remains unknown after this systematic review due to heterogeneity between included studies leading to an inability to provide evidence-based consensus guidance.
确定腋窝清扫术后引流管理的循证最佳策略。
尽管过去 20-30 年的随机对照试验解决了这个问题，但对于腋窝清扫术后何时应拔除引流管，尚无广泛接受的共识。
我们检索了电子数据库 Medline、Embase、Cinahl、Cochrane 系统评价图书馆和 Web of Science 引文索引。还对已确定研究中的参考文献进行了检索。根据 Cochrane 协作数据提取模板，两名独立研究人员根据预先确定的方案独立识别研究并提取数据。根据已发表的标准确定有效性。通过共识纠正差异。
早期和晚期拔管的感染率无差异，较早拔管可缩短住院时间，引流前总引流量较高预测随后发生血清肿。从文献中无法确定腋窝清扫术后引流管的最佳拔管时间。
由于纳入研究之间存在异质性，导致无法提供基于证据的共识指导，因此，经过系统评价后，腋窝清扫术后引流管的最佳拔管时间仍不清楚。
