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氰基丙烯酸酯粘合剂减少改良根治性乳房切除术或象限切除术加淋巴结清扫术后的血清肿形成:一项前瞻性随机临床试验。

Cyanoacrylate Adhesive Reduces Seroma Production After Modified Radical Mastectomy or Quadrantectomy With Lymph Node Dissection-A Prospective Randomized Clinical Trial.

机构信息

First Medical Propaedeutic Surgical Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Third Surgical Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Clin Breast Cancer. 2017 Dec;17(8):595-600. doi: 10.1016/j.clbc.2017.04.004. Epub 2017 Apr 13.

Abstract

INTRODUCTION

The accumulation of fluid, a seroma, is a frequent complication after modified radical mastectomy or quadrantectomy with lymph node dissection. The aim of the present study was to examine whether a new adhesive material made of cyanoacrylate can effectively provide a sealing coat to tissues and thus reduce the incidence of seroma significantly.

PATIENTS AND METHODS

The present prospective, randomized case-control study included 128 women with a breast cancer diagnosis and scheduled for modified radical mastectomy or quadrantectomy with lymph node dissection in Thessaloniki, Greece. In 64 patients (cases), a cyanoacrylate adhesive was applied at the operative field after removal of the tumor and lymph nodes; the remaining 64 patients served as the controls.

RESULTS

Seroma production (P = .001), drainage duration (P = .001), and drainage amount (P = .001) were all significantly less for cases than for controls. The results from a stepwise multiple regression model incorporating the use of adhesive, body mass index, tumor size, and number of infiltrated lymph nodes were significant and able to explain 51.6% of the variability in seroma amount.

CONCLUSION

The results of our study have demonstrated that the cyanoacrylate adhesive can contribute to the reduction of seromas produced after mastectomy and subsequently decrease the duration of postoperative drainage and the frequency of seroma aspirations. However, because the pathogenesis of seroma formation is multifaceted and complex, further research of larger sample sizes is required to confirm the results of our study.

摘要

简介

在改良根治性乳房切除术或象限切除术加淋巴结清扫后,液体积聚(血清肿)是一种常见的并发症。本研究旨在探讨一种新型氰基丙烯酸酯粘合剂是否能有效地为组织提供密封涂层,从而显著降低血清肿的发生率。

患者和方法

本前瞻性、随机病例对照研究纳入了 128 名在希腊塞萨洛尼基接受改良根治性乳房切除术或象限切除术加淋巴结清扫的乳腺癌患者。在 64 例患者(病例组)中,在切除肿瘤和淋巴结后,在手术部位应用氰基丙烯酸酯粘合剂;其余 64 例患者作为对照组。

结果

病例组血清肿的产生(P=0.001)、引流时间(P=0.001)和引流量(P=0.001)均显著低于对照组。纳入粘合剂使用、体重指数、肿瘤大小和浸润淋巴结数量的逐步多元回归模型的结果具有统计学意义,能够解释 51.6%的血清肿量的变异性。

结论

我们的研究结果表明,氰基丙烯酸酯粘合剂可以减少乳房切除术后产生的血清肿,从而减少术后引流时间和血清肿抽吸的频率。然而,由于血清肿形成的发病机制是多方面的,因此需要进一步进行更大样本量的研究来验证我们的研究结果。

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