Cong Yizi, Cao Jianqiao, Qiao Guangdong, Zhang Song, Liu Xinjie, Fang Xiaoming, Zou Haidong, Zhu Shiguang
Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Surgery Department of West Area, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
J Breast Cancer. 2020 Oct;23(5):533-541. doi: 10.4048/jbc.2020.23.e51.
Seroma formation is a common complication in breast cancer patients undergoing mastectomy, and it negatively affects patient recovery after surgery. The present study aimed to evaluate a simple method using fascia suture technique to fix the flap and reduce the incidence of seroma.
A single-center, prospective, randomized controlled trial was carried out among 160 patients who had undergone mastectomy from May 2018 to September 2019. All patients were randomly divided into the fascia suture group (n = 80) or control group (n = 80) and were followed up for at least 3 months for the assessment of immediate and late complications after surgery.
No significant differences were observed between the 2 groups with regard to the basic characteristics. Duration of surgery in the fascia suture group was longer by about 6 minutes compared with that in the control group (114.93 ± 13.67 minutes vs. 108.81 ± 15.20 minutes, = 0.008). The fascia suture group had a shorter duration of drain placement (10.99 ± 3.26 days vs. 13.85 ± 5.37 days, < 0.001), a smaller volume of the total drainage (460.95 ± 242.92 mL vs. 574.83 ± 285.23 mL, = 0.007), and the first 3-day drainage (224.96 ± 101.01 mL vs. 272.3 ± 115.47 mL, = 0.006), compared with the control group. The incidence of seroma formation (G2 or G3) was significantly lower in the fascia suture group compared with the control group (28.8% vs. 12.5%, = 0.033). Besides, there was no statistical difference between the 2 groups in the assessment of other complications, including postoperative pain, hematoma, surgical site infections, flap necrosis, and skin dimpling (all > 0.050).
The fascia suture technique is a simple and effective method for reducing seroma formation and should be used to prevent seroma formation after mastectomy.
Chinese Clinical Trials Registry Identifier: ChiCTR1800015913.
血清肿形成是接受乳房切除术的乳腺癌患者常见的并发症，它会对患者术后恢复产生负面影响。本研究旨在评估一种使用筋膜缝合技术固定皮瓣以降低血清肿发生率的简单方法。
对2018年5月至2019年9月期间接受乳房切除术的160例患者进行了一项单中心、前瞻性、随机对照试验。所有患者被随机分为筋膜缝合组（n = 80）或对照组（n = 80），并随访至少3个月，以评估术后近期和远期并发症。
两组在基本特征方面未观察到显著差异。筋膜缝合组的手术时间比对照组长约6分钟（114.93 ± 13.67分钟 vs. 108.81 ± 15.20分钟，P = 0.008）。与对照组相比，筋膜缝合组的引流管放置时间更短（10.99 ± 3.26天 vs. 13.85 ± 5.37天，P < 0.001），总引流量更少（460.95 ± 24,2.92 mL vs. 574.83 ± 285.23 mL，P = 0.007），以及前3天引流量更少（224.96 ± 101.01 mL vs. 272.3 ± 115.47 mL，P = 0.006）。筋膜缝合组血清肿形成（G2或G3）的发生率显著低于对照组（28.8% vs. 12.5%，P = 0.033）。此外，两组在其他并发症评估方面无统计学差异，包括术后疼痛、血肿、手术部位感染、皮瓣坏死和皮肤凹陷（均P > 0.050）。
筋膜缝合技术是一种简单有效的减少血清肿形成的方法，应用于预防乳房切除术后血清肿的形成。
中国临床试验注册标识符：ChiCTR1800015913。
