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沙培林与明胶海绵在降低乳腺癌患者腋窝淋巴结清扫术后积液方面的前瞻性比较。

Prospective comparison of Sapylin and Avitene for reducing hydrops after axillary lymphadenectomy in breast cancer patients.

作者信息

Zhao Jinghua, Su Fengxi, Hu Yue, Wu Jiannan, Yang Yaping, Liu Fengtao, Gu Ran, Jia Weijuan

机构信息

Breast Tumor Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China.

Breast Tumor Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China.

出版信息

J Surg Res. 2017 Apr;210:8-14. doi: 10.1016/j.jss.2016.10.032. Epub 2016 Nov 5.

Abstract

BACKGROUND

This study compared the efficacy of Sapylin and Avitene in reducing postoperative axillary seroma formation and effusion when applied topically after axillary lymphadenectomy.

METHODS

A total of 224 patients were randomly divided into a Sapylin treatment group (STG), an Avitene treatment group, and a control group (CG). All patients underwent axillary lymphadenectomy and were treated during surgery with Sapylin, Avitene, or neither according to their group assignment. The duration and amount of postoperative drainage, as well as the occurrence of seromas were recorded. Outcomes were compared by one-way analysis of variance and chi-square tests.

RESULTS

Baseline patient data, including age, body mass index, history of neoadjuvant chemotherapy, type of surgery, number of resected lymph nodes, and number of positive metastases did not differ among the three groups. Patients in both the STG and the Avitene treatment group experienced significantly fewer days of drainage than those in the CG; there was no significant difference in drainage tube retention time between the two treated groups. The STG experienced significantly less drainage volume than the CG. Fewer patients in both treatment groups required seroma treatment or experienced complications compared with CG patients.

CONCLUSIONS

Both Sapylin and Avitene effectively reduced postoperative subcutaneous fluid accumulation after axillary lymphadenectomy. These treatments may be particularly useful for breast cancer patients at high risk of seroma formation, especially those with hypertension, diabetes mellitus, or a high body mass index who undergo axillary lymphadenectomy.

摘要

背景

本研究比较了沙培林和微纤维止血胶原在腋窝淋巴结清扫术后局部应用时减少术后腋窝血清肿形成和积液的疗效。

方法

总共224例患者被随机分为沙培林治疗组(STG)、微纤维止血胶原治疗组和对照组(CG)。所有患者均接受腋窝淋巴结清扫术,并在手术期间根据分组接受沙培林、微纤维止血胶原治疗或不接受任何治疗。记录术后引流的持续时间和量以及血清肿的发生情况。通过单因素方差分析和卡方检验比较结果。

结果

三组患者的基线数据,包括年龄、体重指数、新辅助化疗史、手术类型、切除淋巴结数量和阳性转移灶数量,差异无统计学意义。STG组和微纤维止血胶原治疗组患者的引流天数均显著少于CG组;两个治疗组之间的引流管留置时间差异无统计学意义。STG组的引流量显著少于CG组。与CG组患者相比,两个治疗组中需要治疗血清肿或出现并发症的患者较少。

结论

沙培林和微纤维止血胶原均能有效减少腋窝淋巴结清扫术后的皮下积液。这些治疗方法可能对血清肿形成风险较高的乳腺癌患者特别有用,尤其是那些患有高血压、糖尿病或体重指数较高且接受腋窝淋巴结清扫术的患者。

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