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等离子电切术对乳腺癌根治术切口愈合及并发症的影响

The effect of plasmakinetic cautery on wound healing and complications in mastectomy.

机构信息

Department of General Surgery, Ankara Oncology Training and Education Hospital, Ankara, Turkey.

出版信息

J Breast Cancer. 2013 Jun;16(2):198-201. doi: 10.4048/jbc.2013.16.2.198. Epub 2013 Jun 28.

Abstract

PURPOSE

Surgical equipment used in breast cancer surgery that affects wound healing and minimizes complications seems to be a popular investigation topic. The aim of this study is to evaluate the effect of plasmakinetic cautery on wound healing in patients receiving mastectomy.

METHODS

Forty-six consecutive breast cancer patients receiving modified radical mastectomy were evaluated prospectively. Plasmakinetic cautery was used in 24 operations and electrocautery was used in 22 operations in random order to manage skin flaps and excise breast tissue. In the postoperative period, vacuum drainage amount and duration time as well as the start time of arm exercises were recorded. Complications like seroma, surgical site infection, hematoma, and flap necrosis were determined.

RESULTS

Age, body mass index, breast volume and flap area parameters were similar in each group. Mean drainage duration was found to be 5.5 days in the plasmacautery group and 7.9 days in the electrocautery group (p=0.020). In the plasmacautery and electrocautery groups, mean drainage volume was 707 and 1,093 mL, respectively (p=0.025). There was no statistical significance between the groups when operation duration, amount of blood loss, time to start arm exercises, seroma, hematoma, surgical site infection, and flap necrosis were considered.

CONCLUSION

Plasmakinetic cautery is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal tissue injury. So, plasmacautery shortens the drainage amount and duration time compared to electrocautery without elongating operation duration or increasing the amount of blood loss.

摘要

目的

影响伤口愈合并最大限度减少并发症的乳腺癌手术用外科设备似乎是一个热门的研究课题。本研究旨在评估等离子电切术对接受乳腺癌改良根治术患者伤口愈合的影响。

方法

前瞻性评估了 46 例连续接受改良根治术的乳腺癌患者。随机采用等离子电切术(24 例)和电凝术(22 例)处理皮瓣和切除乳房组织。术后记录真空引流量和引流时间以及开始手臂锻炼的时间。确定血清肿、手术部位感染、血肿和皮瓣坏死等并发症。

结果

两组患者的年龄、体重指数、乳房体积和皮瓣面积参数相似。等离子电切组的平均引流时间为 5.5 天,电凝组为 7.9 天(p=0.020)。等离子电切组和电凝组的平均引流量分别为 707 和 1093mL(p=0.025)。考虑手术时间、出血量、开始手臂锻炼的时间、血清肿、血肿、手术部位感染和皮瓣坏死等因素时,两组间无统计学意义。

结论

等离子电切术是一种有前途的新型手术器械,具有无创伤、手术刀般的切割精度和电外科样的止血效果,导致组织损伤最小。因此,与电凝术相比,等离子电切术可减少引流量和引流时间,而不会延长手术时间或增加出血量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78a2/3706866/13a70fba8401/jbc-16-198-g001.jpg

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