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乳腺癌根治术后短期和长期引流并发症的评估:一项随机临床试验。

Evaluation of Complications of Short-term and Long-term Drainage Following Mastectomy with Removal of Axillary Lymph Nodes: A Randomized Clinical Trial.

机构信息

Department of Surgery, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Asian Pac J Cancer Prev. 2022 Aug 1;23(8):2873-2878. doi: 10.31557/APJCP.2022.23.8.2873.

Abstract

BACKGROUND

Breast cancer is one of the most common cancers in Iran and round the globe. Seroma formation is the most common primary complication after mastectomy (partial/radical). Nowadays, drainage is used as a routine method to reduce seroma formation after mastectomy, although there is no consensus about the appropriate time to perform drainage after this surgery. This study evaluated the effects of short-term and long-term drainage after mastectomy along with removal of axillary lymph nodes.

METHODS

This randomized clinical trial was performed on 88 women who underwent mastectomy with ALND in hospitals in Yazd (were randomly divided into two groups). Suction drains were inserted for all patients at completion of surgery. The data collection tool was a researcher-made form based on variables. In the first group, the drain was removed 24 hours after surgery and the patients were discharged, but the second group was discharged with the drain in place after 24 hours and the drain was removed 5 days after surgery. Data were analyzed with SPSS18 using T-Test, Chi square, and Mann-Whitney U test.

RESULTS

The results showed that 28 (31.8%) participants had formed seroma, of whom 22 (50%) were in the 1-day drainage group and 6 (13.6%) were in the 5-day drainage group. There was a statistically significant correlation among seroma frequency, mean aspiration volume, mean number of aspirations, mean seroma volume in sonography one week after surgery, and mean seroma volume in sonography between the two groups three weeks after surgery (P<0.05).

CONCLUSION

Based on the results, it can be concluded that long-term drainage reduces the risk of seroma formation after mastectomy with removal of axillary lymph nodes compared to short-term drainage. Complementary study be performed by considering other underlying factors such as comorbidities to obtain the best drain removal time in breast cancer patients.

摘要

背景

乳腺癌是伊朗和全球最常见的癌症之一。在乳腺癌根治术或改良根治术后,血清肿是最常见的原发性并发症。目前,引流被作为一种常规方法用于减少乳腺癌根治术后血清肿的形成,但对于术后何时开始引流,尚无统一意见。本研究旨在评估乳腺癌根治术联合腋窝淋巴结清扫术后短期和长期引流对血清肿形成的影响。

方法

这是一项在亚兹德医院进行的随机临床试验,共纳入 88 例行乳腺癌根治术联合腋窝淋巴结清扫术的女性患者(随机分为两组)。所有患者在手术完成后均插入引流管。数据收集工具是基于变量的研究者自制表格。在第一组中,引流管在术后 24 小时内移除,患者出院,但第二组在术后 24 小时内带管出院,引流管在术后 5 天移除。使用 SPSS18 软件进行 T 检验、卡方检验和 Mann-Whitney U 检验对数据进行分析。

结果

结果显示,28 名(31.8%)参与者形成了血清肿,其中 1 天引流组有 22 名(50%),5 天引流组有 6 名(13.6%)。血清肿频率、平均抽吸量、平均抽吸次数、术后一周超声检查平均血清肿体积和术后 3 周超声检查平均血清肿体积在两组之间存在统计学显著相关性(P<0.05)。

结论

基于研究结果,可以得出结论,与短期引流相比,长期引流可降低乳腺癌根治术联合腋窝淋巴结清扫术后血清肿形成的风险。考虑到其他潜在因素,如合并症,进行补充研究以确定乳腺癌患者最佳的引流管移除时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9741876/8c3817647db3/APJCP-23-2873-g001.jpg

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