Baker Elizabeth, Piper Jennifer
York Teaching Hospitals NHS Foundation Trust, United Kingdom.
York Teaching Hospitals NHS Foundation Trust, United Kingdom.
Surgeon. 2017 Oct;15(5):267-271. doi: 10.1016/j.surge.2015.12.007. Epub 2016 Feb 19.
Practice regarding the use of post operative drains after simple mastectomy varies widely. This project aimed to establish if not using a drain lead to an increase in post-operative seroma formation or other complications.
Women undergoing simple mastectomy ± sentinel node biopsy were included. Patients were allocated to drain/no drain group via operating surgeon. Data was collected retrospectively from computer based records. Drain output, length of stay, seroma formation and volume and post-operative complications were recorded.
There were 39 patients in the drain group and 24 patients in the no drain group. Patients did not differ significantly in terms of age, BMI or specimen weight. Seroma was more prevalent in the no drain group (62 v 83%) and required more clinic attendances for aspiration with larger volumes drained (360 vs 725 ml, p = 0.0096). There was no difference in overall complication rate. There did not appear to be a correlation between seroma formation and age, BMI or mastectomy weight.
The use of a drain after simple mastectomy may confer lower rates of seroma formation as well as lower overall volumes. Therefore drainless mastectomy appears to be safe but may require more post-operative intervention.
单纯乳房切除术后使用术后引流管的做法差异很大。本项目旨在确定不使用引流管是否会导致术后血清肿形成增加或其他并发症。
纳入接受单纯乳房切除术±前哨淋巴结活检的女性。患者由主刀医生分配至引流/不引流组。数据通过计算机记录进行回顾性收集。记录引流量、住院时间、血清肿形成情况及体积以及术后并发症。
引流组有39例患者，不引流组有24例患者。患者在年龄、体重指数或标本重量方面无显著差异。血清肿在不引流组更为普遍（62%对83%），且抽吸所需的门诊就诊次数更多，引流量更大（360 vs 725 ml，p = 0.0096）。总体并发症发生率无差异。血清肿形成与年龄、体重指数或乳房切除重量之间似乎没有相关性。
单纯乳房切除术后使用引流管可能会降低血清肿形成率以及总体积。因此，无引流乳房切除术似乎是安全的，但可能需要更多的术后干预。
