Fatima Sayyam, Shafique Muhammad Salman, Shabana Bushra, Nawaz Sumaira, Khan Jahangir S, Hasan Syed Waqas
Department of Surgical Unit I, Holy Family Hospital, Rawalpindi, PAK.
Department of General Surgery, Chesterfield Royal Hospital, Chesterfield, GBR.
Cureus. 2024 Feb 27;16(2):e55017. doi: 10.7759/cureus.55017. eCollection 2024 Feb.
Introduction Seroma formation is the most common complication after modified radical mastectomy (MRM). It leads to increased pain and discomfort, potentially prolonging morbidity and treatment. Various treatment modalities are being used to decrease the incidence of seroma formation. The objective of this study was to compare intravenous hydrocortisone injection versus placebo in patients undergoing MRM in terms of frequency of post-operative seroma formation. Methods This randomized, double-blinded, placebo-controlled study was conducted at Surgical Unit-I, Holy Family Hospital, Rawalpindi, Pakistan from January 2021 to December 2021. A total of 152 female patients were randomly assigned to each of the study and placebo groups. Group I patients received 100 mg of hydrocortisone intravenously while group II patients received one ml of 0.9% normal saline intravenously prior to induction of general anesthesia for MRM. The incidence of seroma formation after 10 days of MRM and total drain volume till their removal was measured in all patients. Results The mean age was 48.42±10.15 in Group I, while it was 47.67±10.75 in Group II. Mean drain output till removal was 99.14±31.01 ml in the hydrocortisone group and 177.57±63.37 ml in the placebo group. Forty-eight patients developed seroma (31.58%), of whom nine received intravenous hydrocortisone and 39 received normal saline (P=0.000). Conclusion Intravenous hydrocortisone is effective in terms of frequency of post-operative seroma formation as compared to placebo in patients undergoing MRM.
引言
血清肿形成是改良根治性乳房切除术(MRM)后最常见的并发症。它会导致疼痛和不适加剧,可能延长发病时间和治疗周期。目前正在使用各种治疗方法来降低血清肿形成的发生率。本研究的目的是比较静脉注射氢化可的松与安慰剂对接受MRM患者术后血清肿形成频率的影响。
方法
本随机、双盲、安慰剂对照研究于2021年1月至2021年12月在巴基斯坦拉瓦尔品第圣家族医院第一外科进行。共有152名女性患者被随机分配到研究组和安慰剂组。第一组患者在进行MRM全身麻醉诱导前静脉注射100毫克氢化可的松,而第二组患者静脉注射1毫升0.9%生理盐水。测量所有患者MRM术后10天血清肿形成的发生率以及直至引流管拔除时的总引流量。
结果
第一组的平均年龄为48.42±10.15岁,而第二组为47.67±10.75岁。氢化可的松组直至引流管拔除时的平均引流量为99.14±31.01毫升,安慰剂组为177.57±63.37毫升。48名患者发生了血清肿(31.58%),其中9名接受了静脉注射氢化可的松,39名接受了生理盐水(P = 0.000)。
结论
与安慰剂相比,静脉注射氢化可的松在接受MRM的患者术后血清肿形成频率方面是有效的。