Sharma Shivam, Arora Jainendra K, Kumar Rakesh
General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cancer Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus. 2022 Dec 21;14(12):e32789. doi: 10.7759/cureus.32789. eCollection 2022 Dec.
Introduction Modified radical mastectomy is a common modality used in treating breast cancer and often presents a series of post-operative challenges. Seroma formation is the most common complication with no single method shown to be reliably effective against it. Fibrin glue is one such modality. There is a paucity of studies describing the utility of fibrin glue to prevent seroma formation. Aim To evaluate the effect of intraoperative application of fibrin glue sealant on drain output and seroma formation in patients undergoing modified radical mastectomy by comparing outcomes between the two groups. Method This is a prospective observational study. Fibrin glue application was done intra-operatively prior to closure in one group. Standard closure procedures with drain placement were undertaken in another group and their outcomes were analyzed for both groups. Results Drain output on postoperative day 1 (POD 1) as well as total drain output were recorded for both groups and the difference in mean was found to be significant (p<<0.05 and 0.049, respectively. Distribution of patients according to the volume of seroma formation was done; this difference of means was also found to be significant (p=0.004). Further, the difference of mean for the number of days the drain was in-situ was found to be significant. Conclusion Fibrin sealant used during modified radical mastectomy closures decreased the rates and volumes of seroma formation. This led to quicker drain removals and less patient discomfort.
引言 改良根治性乳房切除术是治疗乳腺癌的常用术式，术后常面临一系列挑战。血清肿形成是最常见的并发症，尚无单一方法被证明对其有可靠疗效。纤维蛋白胶就是其中一种方法。描述纤维蛋白胶预防血清肿形成效用的研究较少。目的 通过比较两组患者的结局，评估术中应用纤维蛋白胶封闭剂对改良根治性乳房切除术患者引流液量及血清肿形成的影响。方法 这是一项前瞻性观察研究。一组在术中关闭切口前应用纤维蛋白胶。另一组采用放置引流管的标准关闭程序，并对两组的结局进行分析。结果 记录两组术后第1天（POD 1）的引流液量以及总引流液量，发现均值差异有统计学意义（分别为p<<0.05和0.049）。根据血清肿形成量对患者进行分类；均值差异也有统计学意义（p = 0.004）。此外，发现引流管留置天数的均值差异有统计学意义。结论 在改良根治性乳房切除术关闭切口时使用纤维蛋白封闭剂可降低血清肿形成的发生率和量。这使得引流管拔除更快，患者不适感减轻。
