Ebner Florian, Schramm Amelie, Bottke Dirk, Friedl Thomas Wp, Wiegel Thomas, Fink Visnja, Lato Kristian, Bekes Inga, Janni Wolfgang, de Gregorio Nikolaus
Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
Klinik für Strahlentherapie und Radioonkologie, Universität Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Arch Gynecol Obstet. 2016 Oct;294(4):861-6. doi: 10.1007/s00404-016-4124-8. Epub 2016 Jun 2.
One of the most common complications in breast conserving surgery is seroma formation. The origin of seroma formation remains unclear. While intraoperative radiotherapy (IORT) has been shown to be an alternative to whole breast irradiation, the influence on seroma production is unclear. Therefore, this analysis compares seroma production in patients with breast conserving surgery with or without IORT as tumour bed boost during breast conserving surgery.
A retrospective analysis of seroma production in patients with nodal-negative (pN0sn) pT1/2 primary breast cancer treated between September 2010 and October 2013 at the Breast Cancer Centre, University Hospital Ulm was performed. Patients with neoadjuvant chemotherapy, previous breast/axillary surgery or more than one intervention were excluded. IORT was applied as a tumour bed boost with 50-kV X-rays (Intra beam(®)) delivering 9 Gy at the applicator surface. Seroma formation was measured using wound drains placed in breast and in axilla.
Data of 152 patients (99 -IORT; 53 +IORT) were available for analysis. No significant differences between patients with or without IORT with regard to seroma production and number of days until drain removal were found (all p > 0.05).
Patients with IORT encountered no increased seroma production and removal of the drains was not delayed compared to patients with breast conserving surgery only. Our results indicate that IORT does not increase the seroma production compared to surgery alone.
保乳手术最常见的并发症之一是血清肿形成。血清肿形成的原因尚不清楚。虽然术中放疗（IORT）已被证明是全乳放疗的一种替代方法，但其对血清肿产生的影响尚不清楚。因此，本分析比较了保乳手术中接受或未接受IORT作为瘤床加量放疗的患者血清肿的产生情况。
对2010年9月至2013年10月在乌尔姆大学医院乳腺癌中心接受治疗的淋巴结阴性（pN0sn）pT1/2原发性乳腺癌患者血清肿的产生情况进行回顾性分析。排除接受新辅助化疗、既往有乳房/腋窝手术或进行过不止一次干预的患者。术中放疗采用50 kV X射线（Intra beam(®)）作为瘤床加量放疗，在施源器表面给予9 Gy剂量。使用置于乳房和腋窝的伤口引流管来测量血清肿的形成情况。
152例患者的数据（99例接受IORT；53例未接受IORT）可供分析。在血清肿产生情况以及引流管拔除前的天数方面，接受IORT和未接受IORT的患者之间未发现显著差异（所有p>0.05）。
与仅接受保乳手术的患者相比，接受术中放疗的患者血清肿产生并未增加，引流管拔除也未延迟。我们的结果表明，与单纯手术相比，术中放疗不会增加血清肿的产生。
