Subramanian Preethi, Arumugam Murugan, Vaithianathan Rajan
Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Sree Balaji Vidyapeeth University (SBVU), Puducherry, India.
Indian J Cancer. 2023 Apr-Jun;60(2):206-210. doi: 10.4103/ijc.IJC_1008_20.
Seroma formation after mastectomy with axillary dissection is a major source of morbidity and results in a significant delay in starting the adjuvant treatment. Many different strategies, including the usage of steroids, have been tried to reduce the incidence of seroma with varying outcomes. This study aimed to assess the effect of a single dose of intracavitary methylprednisolone (MP) on seroma formation in patients undergoing total mastectomy with axillary lymph node dissection (ALND).
A randomized controlled trial was conducted at our institute, from January 2018 till June 2019. In the intervention group of 36 patients, 80 mg of MP solution was injected into the wound on post operative day 1. The drain was clamped for 8 hours and then released. In the control group of 36 patients, saline was administered and the drain output was compared between the groups.
The mean drain volume in the intervention group was 409.08 mL and in the control group it was 566.97 mL (P < 0.005). The mean drain removal time was 7.86 days and 10.33 days in the intervention and control group, respectively (P < 0.0004).
A single dose of intracavitary MP significantly reduced seroma formation and facilitated early removal of drain in patients undergoing total mastectomy with ALND.
乳房切除术后腋窝淋巴结清扫术后血清肿形成是发病的主要原因，导致辅助治疗开始的显著延迟。已经尝试了许多不同的策略，包括使用类固醇，以降低血清肿的发生率，但结果各不相同。本研究旨在评估单剂量腔内注射甲基强的松龙（MP）对接受全乳房切除术加腋窝淋巴结清扫术（ALND）患者血清肿形成的影响。
2018年1月至2019年6月在我院进行了一项随机对照试验。在36例患者的干预组中，术后第1天在伤口内注射80mg MP溶液。引流管夹闭8小时后松开。在36例患者的对照组中，给予生理盐水，并比较两组的引流量。
干预组的平均引流量为409.08mL，对照组为566.97mL（P<0.005）。干预组和对照组的平均拔管时间分别为7.86天和10.33天（P<0.0004）。
单剂量腔内注射MP显著减少了接受全乳房切除术加ALND患者的血清肿形成，并促进了引流管的早期拔除。
