Wu Yuhui, Wang Shouman, Hai Jian, Mao Jie, Dong Xue, Xiao Zhi
Department of Breast Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, P. R. China, 410008.
Clinical Research Center For Breast Cancer Control and Prevention In Human Province, Changsha, P. R. China.
BMC Surg. 2020 Apr 6;20(1):65. doi: 10.1186/s12893-020-00725-8.
The aim of this study was to compare quilting suture with conventional suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph nodes biopsy (SLN) or axillary lymph nodes dissection (ALND) for breast cancer.
Two hundred thirty-five consecutive breast cancer patients were retrospectively analyzed. The primary outcome was the incidence of Grade 2 or Grade 3 seroma at anterior pectoral area within 1 month postoperatively. We categorized seroma into early or late seroma according to the drainage removal time. Cox regression was used for analysis.
The incidence of Grade 2 and 3 seroma was significantly higher in the conventional suture group compared with that in the quilting suture group (19.3% vs. 9.5%, p = 0.032), which was attributed to the late seroma in Grade 2 and 3. Quilting suture was associated with longer time for fixing flaps compared with that of conventional suture (504.7 s vs. 109.1 s, p < 0.001), but with less volume of drainage. Old age, high body mass index and conventional suture were independently risk factors for Grade 2 and 3 seroma.
Quilting suture decreased the incidence of Grade 2 and 3 seroma at pectoral area within 1 month after mastectomy, especially the late seroma in Grade 2 and 3.
本研究旨在比较在乳腺癌前哨淋巴结活检（SLN）或腋窝淋巴结清扫（ALND）后乳房切除术（ME）中，褥式缝合与传统缝合在胸肌区域血清肿形成方面的差异。
对235例连续性乳腺癌患者进行回顾性分析。主要结局指标为术后1个月内胸前区2级或3级血清肿的发生率。我们根据引流去除时间将血清肿分为早期或晚期血清肿。采用Cox回归进行分析。
传统缝合组2级和3级血清肿的发生率显著高于褥式缝合组（19.3%对9.5%，p = 0.032），这归因于2级和3级的晚期血清肿。与传统缝合相比，褥式缝合固定皮瓣的时间更长（504.7秒对109.1秒，p < 0.001），但引流量更少。年龄较大、体重指数较高和传统缝合是2级和3级血清肿的独立危险因素。
褥式缝合降低了乳房切除术后1个月内胸肌区域2级和3级血清肿的发生率，尤其是2级和3级的晚期血清肿。
