Rozhl Chir. 2020 Winter;99(11):502-508.
The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence.
144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases.
Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023).
In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.
本研究旨在回顾性分析对比使用超声刀和传统结扎技术行腋窝清扫术患者的并发症发生率，评估其并发症发生率，并分析并发症发生的危险因素。
纳入 2014 年 1 月至 2019 年在单中心接受腋窝清扫术的 144 例患者，共 148 侧腋窝。73 例采用超声刀，70 例采用可吸收缝线结扎。
超声刀组 41 例（56.2%）和结扎组 21 例（30.0%）发生血清肿（p=0.003）。超声刀组引流管拔除时间为 4.0 天，结扎组为 3.0 天（p<0.001）。超声刀组乳腺癌根治术后引流液量为 300.9ml，保乳术后引流液量为 241.9ml；结扎组乳腺癌根治术后引流液量为 168.7ml，保乳术后引流液量为 107.4ml（p=0.005；p=0.023）。
与传统可吸收缝线结扎相比，超声刀行腋窝清扫术显著增加术后血清肿形成的风险，延长引流管拔除时间，增加引流量。
