Torresetti Matteo, Scalise Alessandro, Pelliccioni Michele, Taddei Francesco Mauro Junior, Di Benedetto Giovanni
Clinic of Plastic and Reconstructive Surgery, Department of Experimental and Clinical Medicine, Marche Polytechnic University Medical School, Ancona, Italy.
Plast Reconstr Surg Glob Open. 2022 Nov 3;10(11):e4642. doi: 10.1097/GOX.0000000000004642. eCollection 2022 Nov.
The real benefit of using drains for reducing the risk of complications in sentinel lymph node biopsy (SLNB) has not been investigated yet. We aimed to evaluate the role of drain after SLNB and to determine if a correlation exists between drains and early complications.
This is a retrospective study of patients who underwent SLNB for melanoma from 2016 to 2021. Patients were dichotomized into two groups according to the use of drain. The between-group comparison (drainage group versus no drainage group) was performed by using Mann-Whitney U test and chi-square test. A regression analysis was conducted to identify predictors of complications.
Of 218 individuals analyzed, 18 (8.4%) had postoperative complications. The most common complications were seroma (5.1%) and wound dehiscence (1.4%). The between-group analysis showed no significant differences in complication rate, whereas the operative time was significantly higher in the drainage group ( = 0.007), as well as the hospital stay ( ≤ 0.0001) and the duration of postoperative antibiotic therapy ( = 0.02). The regression analysis found body mass index and multiple basins of SLNB (axilla with groin) to be significant predictors of having a complication ( = 0.03 and = 0.05, respectively). The operative time was found to be a predictor of seroma ( = 0.04).
Drainage use in SLNB prolonged hospital stays and duration of postoperative antibiotic therapy, thus resulting in higher costs. The preemptive use of drainage is suggested in selected settings of patients.
使用引流管降低前哨淋巴结活检（SLNB）并发症风险的实际益处尚未得到研究。我们旨在评估SLNB后引流管的作用，并确定引流管与早期并发症之间是否存在相关性。
这是一项对2016年至2021年接受黑色素瘤SLNB的患者的回顾性研究。根据是否使用引流管将患者分为两组。采用Mann-Whitney U检验和卡方检验进行组间比较（引流组与无引流组）。进行回归分析以确定并发症的预测因素。
在分析的218例患者中，18例（8.4%）有术后并发症。最常见的并发症是血清肿（5.1%）和伤口裂开（1.4%）。组间分析显示并发症发生率无显著差异，而引流组的手术时间显著更长（P = 0.007），住院时间也显著更长（P ≤ 0.0001），术后抗生素治疗持续时间也更长（P = 0.02）。回归分析发现体重指数和多个SLNB区域（腋窝加腹股沟）是发生并发症的显著预测因素（分别为P = 0.03和P = 0.05）。发现手术时间是血清肿的一个预测因素（P = 0.04）。
SLNB中使用引流管延长了住院时间和术后抗生素治疗持续时间，从而导致成本更高。建议在特定患者群体中预防性使用引流管。
