Khan Maryam Alam
Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Apr-Jun;29(2):207-210.
With the steep increase in breast cancer incidence globally and regionally, there has been a trend toward reducing patient morbidity by meticulous surgical techniques to obviate complications like seroma formation; use to pre-operative steroids seems to be convenient, cost effective and shows promising results in trials.
This randomized clinical trial was conducted at Surgical Department of Khyber Teaching Hospital Peshawar, from January 2012 to April 2014 on 65 patients randomly allocated to Group A and Group B using lottery method. Group A underwent MRM+AD in the conventional manner while Group B received a 120 mg of injection Depomedrol intravenously 1 hour before the surgery. The two were compared in terms of total drainage, days of drainage, wound complications and incidence of seroma. Data was entered and analysed using statistical program SPSS-21.
The mean age in group A was 34.2±10.1 years and B was 32.3±9.1 years. The mean drainage in intervention group was significantly reduced as compared to control group (755.4±65ml vs 928.3±102.5). Total drainage days were reduced (6.5±1.6 days vs 10.2±2.2 days) and incidence of seroma was also reduced (A=18.75% vs B=6.06%). However, three patients in group B had wound infection.
Seroma formation is the most common complication of Mastectomy and among the methods used to reduce its incidence, steroid administration seems to be the most cost effective and shows promising results.
随着全球及区域范围内乳腺癌发病率的急剧上升，出现了一种趋势，即通过精细的手术技术来降低患者的发病率，以避免诸如血清肿形成等并发症；术前使用类固醇似乎方便、具有成本效益且在试验中显示出有前景的结果。
这项随机临床试验于2012年1月至2014年4月在白沙瓦开伯尔教学医院外科进行，对65例患者采用抽签法随机分为A组和B组。A组以传统方式行改良根治性乳房切除术（MRM）加腋窝清扫（AD），而B组在手术前1小时静脉注射120毫克甲泼尼龙。比较两组的总引流量、引流天数、伤口并发症及血清肿发生率。数据使用统计软件SPSS - 21录入并分析。
A组平均年龄为34.2±10.1岁，B组为32.3±9.1岁。与对照组相比，干预组的平均引流量显著减少（755.4±65毫升对928.3±102.5毫升）。总引流天数减少（6.5±1.6天对10.2±2.2天），血清肿发生率也降低（A组 = 18.75%对B组 = 6.06%）。然而，B组有3例患者发生伤口感染。
血清肿形成是乳房切除术最常见的并发症，在用于降低其发生率的方法中，类固醇给药似乎是最具成本效益且显示出有前景结果的方法。
