Garbay Jean-Rémi, Thoury Anne, Moinon Etienne, Cavalcanti Andréa, Palma Mario Di, Karsenti Guillaume, Leymarie Nicolas, Sarfati Benjamin, Rimareix Françoise, Mazouni Chafika
Department of Breast Surgical Oncology, Institut Gustave Roussy, Villejuif, France.
Breast Care (Basel). 2012 Jun;7(3):231-235. doi: 10.1159/000341102. Epub 2012 Jun 27.
After lymphadenectomy for early breast cancer, seroma formation is a constant event requiring a suction drainage. This drainage is the strongest obstacle to reducing the hospital stay. Axillary padding without drainage appears to be a valuable option amid the various solutions for reducing the hospital stay. METHODS: We conducted a comparison between 114 patients with padding and 185 patients with drainage. Data were obtained from 2 successive prospective studies. RESULTS: The mean hospital stay was 2.4 days (range 1-4) in the padding group and 4.2 days (range 2-9) in the drainage group (p < 0.05). There were fewer needle aspirations for seroma in the padding group (8.8 vs. 23%, p < 0.05). At 6 weeks, only 28% (32/114) of the patients in the padding group reported pain versus 51% (94/185) in the drainage group. The mean pain intensity at 6 weeks was 3 and 4.3 respectively (p < 0.0001). CONCLUSION: Axillary padding without drainage was associated with a better post-operative course than suction drainage in this historical comparison, and the hospital stay was significantly shortened. There are only few series published on this new technique but they all indicate good feasibility and good tolerance. A large randomised multicentric evaluation is now warranted.
早期乳腺癌淋巴结清扫术后,血清肿形成是常见情况,需要进行负压引流。这种引流是缩短住院时间的最大障碍。在各种缩短住院时间的解决方案中,不进行引流的腋窝填充似乎是一个有价值的选择。方法:我们对114例使用填充的患者和185例使用引流的患者进行了比较。数据来自2项连续的前瞻性研究。结果:填充组的平均住院时间为2.4天(范围1 - 4天),引流组为4.2天(范围2 - 9天)(p < 0.05)。填充组血清肿穿刺抽吸次数更少(8.8%对23%,p < 0.05)。在6周时,填充组只有28%(32/114)的患者报告有疼痛,而引流组为51%(94/185)。6周时的平均疼痛强度分别为3和4.3(p < 0.0001)。结论:在本次历史对照研究中,不进行引流的腋窝填充与负压引流相比,术后过程更好,住院时间显著缩短。关于这项新技术的系列报道很少,但所有报道均表明其具有良好的可行性和耐受性。现在需要进行大规模随机多中心评估。