Cao Rui, Zhang Jing, Su An, Bao Haoshi, He Zhou, Wu Jiannan
Breast Tumor Center, Sun Yat-Sen University, Guangzhou, China.
Anesthesiology Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Front Oncol. 2025 Sep 10;15:1577591. doi: 10.3389/fonc.2025.1577591. eCollection 2025.
Postoperative chest wall seroma is a common complication following modified radical mastectomy. When persistent, it can lead to the formation of a dense fibrous capsule (pseudobursa), resulting in a refractory seroma that is unresponsive to conventional treatments and may delay essential adjuvant therapies. Surgical excision of the capsule carries significant risks. This study introduces a less invasive surgical technique to manage this challenging condition.
From 2018 to 2021, 20 patients with refractory seroma after modified radical mastectomy were included in this retrospective study. Inclusion required seroma persistence for over one month despite repeated aspirations, with the presence of a fibrous capsule confirmed by ultrasonography. A minimally traumatic, four-step technique was employed under local anesthesia, involving capsule scraping, "cross-hatch" scoring, and flap fixation. A drainage tube was inserted post-procedure. Color Doppler ultrasound was used for pre- and post-procedural assessment.
The study included 20 female patients with a median age of 57.5 years. All patients had node-positive breast cancer. The "cross-hatch" capsular scoring technique was successfully performed in all cases. The median postoperative drainage time was 7 days (range 6-12 days). During a median follow-up of 3 months, no seroma recurrence was observed. The procedure was well-tolerated with minimal pain, and no significant complications such as hematoma or infection occurred.
The "cross-hatch" capsular scoring technique is a safe, effective, and less invasive method for managing refractory post-mastectomy seroma. This approach minimizes patient trauma, reduces recovery time, and helps maintain the continuity of adjuvant therapies, thereby offering a valuable alternative to more aggressive surgical interventions.
术后胸壁血清肿是改良根治性乳房切除术后常见的并发症。如果持续存在，可导致致密纤维囊（假囊）形成，产生对传统治疗无反应的难治性血清肿，并可能延迟必要的辅助治疗。囊的手术切除具有重大风险。本研究引入一种侵入性较小的手术技术来处理这种具有挑战性的情况。
2018年至2021年，本回顾性研究纳入了20例改良根治性乳房切除术后难治性血清肿患者。纳入标准为尽管反复抽吸，血清肿仍持续存在超过1个月，且超声检查证实存在纤维囊。在局部麻醉下采用一种微创的四步技术，包括囊刮除、“交叉划线”评分和皮瓣固定。术后插入引流管。术前和术后使用彩色多普勒超声进行评估。
该研究纳入了20例女性患者，中位年龄为57.5岁。所有患者均为淋巴结阳性乳腺癌。所有病例均成功实施了“交叉划线”囊评分技术。术后中位引流时间为7天（范围6 - 12天）。在中位3个月的随访期间，未观察到血清肿复发。该手术耐受性良好，疼痛轻微，未发生血肿或感染等重大并发症。
“交叉划线”囊评分技术是一种安全、有效且侵入性较小的处理乳房切除术后难治性血清肿的方法。这种方法可将患者创伤降至最低，减少恢复时间，并有助于维持辅助治疗的连续性，从而为更激进的手术干预提供了一种有价值的替代方案。
