El-Omar Omar, Akbani Umair, Abdelrahman Abdelrahim, Akbari Amir R, Said Umar N, Ismail Omar M, Butaliu Cristian, Paul Ashok S
The Regional Sarcoma Centre, Manchester Royal Infirmary, Manchester, GBR.
Obstetrics and Gynaecology, King's Mill Hospital, Mansfield, GBR.
Cureus. 2022 Dec 6;14(12):e32259. doi: 10.7759/cureus.32259. eCollection 2022 Dec.
Background The mainstay of therapy in most soft-tissue tumours (STTs) is excision. However, this often results in blood/extracellular fluid collection within large dead spaces necessitating the use of surgical drains. Whether meticulous attention to haemostasis, careful closure of dead space, and use of compression bandage obviates the need for drains was investigated. This study aimed to compare postoperative outcomes in patients undergoing surgery for STTs with and without the use of drains. Methodology A retrospective analysis of patients undergoing STT surgery over five years was undertaken using a regional STT specialist service database. Patients were stratified into the following two groups: compression bandage alone (CB) versus compression bandage with drain (CBD). The chi-square test was used to examine associations with infection, seroma, and haematoma, while the unpaired t-test was used for associations with hospital stay and time to wound healing. The unpaired t-test with Bonferroni correction was used to account for tumour dimensions across both groups. Results A total of 81 CB and 25 CBD patients were included. The mean hospital stay was significantly lower in CB compared to CBD (4.9 days, SD = 8.574 vs. 9.8 days, SD = 7.647, p = 0.0125). None of the other variables was significantly different between the two groups, including infection (21.3% vs. 24.0%, p = 0.7804), seroma (25.0% vs. 36.0%, p = 0.2865), haematoma (0.026% vs. 2.0%, p = 0.2325), and time to wound healing (55.8 days, SD = 63.59 vs. 42.3 days, SD = 58.88, p = 0.3648). Conclusions Our findings suggest that the use of drains in patients undergoing STT tumour surgery lengthens hospital stay without reducing the incidence of postoperative complications/time to wound healing. A larger, prospective trial is needed.
大多数软组织肿瘤(STT)的主要治疗方法是切除。然而,这常常导致在大的死腔内出现血液/细胞外液积聚,因此需要使用手术引流管。本研究调查了通过严格止血、仔细封闭死腔以及使用加压绷带是否可以避免使用引流管。本研究旨在比较接受STT手术的患者在使用和不使用引流管情况下的术后结果。
使用一个地区性STT专科服务数据库,对五年内接受STT手术的患者进行回顾性分析。患者被分为以下两组:单纯加压绷带组(CB)和带引流管的加压绷带组(CBD)。采用卡方检验来检验与感染、血清肿和血肿的相关性,而采用不成对t检验来检验与住院时间和伤口愈合时间的相关性。采用经Bonferroni校正的不成对t检验来考虑两组间的肿瘤大小。
共纳入81例CB组患者和25例CBD组患者。CB组的平均住院时间显著低于CBD组(4.9天,标准差=8.574;9.8天,标准差=7.647,p=0.0125)。两组间的其他变量均无显著差异,包括感染(21.3%对24.0%,p=0.7804)、血清肿(25.0%对36.0%,p=0.2865)、血肿(0.026%对2.0%,p=0.2325)以及伤口愈合时间(55.8天,标准差=63.59;42.3天,标准差=58.88,p=0.3648)。
我们的研究结果表明,STT肿瘤手术患者使用引流管会延长住院时间,且不会降低术后并发症发生率/伤口愈合时间。需要进行一项更大规模的前瞻性试验。