OBJECTIVE:This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection.METHODS:The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552.RESULTS:The median volume of fluid aspirated was significantly lower in the axillary drainage group (0.00 ml; 0.00 – 270.00) compared to the no drain group (522.50 ml; 130.00 - 1148.75). The median number of aspirations performed during conservative breast cancer treatment was significantly lower in the drainage group (0.5; 0.0 - 4.0) compared to the no drain group (5.0; 3.0 - 7.0). The total volume of serous fluid produced (the volume of fluid obtained from drainage added to the volume of aspirated fluid) was similar in the two groups. Regarding complications, two cases (2.4%) of wound dehiscence occurred in the drainage group compared to 13 cases (13.5%) in the group in which drainage was not performed, with this difference being statistically significant. Rates of infection, necrosis and hematoma were similar in both groups.CONCLUSION:Safety rates were similar in both study groups; hence, axillary dissection can feasibly be performed without drainage. However, more needle aspirations could be required, and there could be more cases of wound dehiscence in patients who do not undergo auxiliary drainage.
Câncer de mama Seroma Drenagem RESUMO Objetivo: Avaliar os sentimentos e as dificuldades vivenciadas pelos pacientes durante a utilização de drenos de sucção. Métodos: Trata-se de um estudo descritivo, transversal, que avaliou mulheres portadoras de câncer de mama submetidas ao tratamento cirúrgico e que permaneceram com dreno de sucção por três dias, no mínimo. Foi avaliada a dificuldade para a realização de atividades diárias, gerais e específicas, assim como os sentimentos negativos desencadeados pela utilização do dreno, por intermédio da aplicação de questionário previamente estabelecido. Resultados: Foram incluídas no estudo 77 pacientes, com média de idade de 49 (±13) anos. Entre a população analisada, 53 pacientes (68,8%) deixaram de realizar alguma tarefa por estar com o dreno. Entre as limitações, destacam-se as dificuldades para "vestir-se" (79,2%) e para "dormir" (87,0%). Entre os sentimentos referidos, encontrou-se prevalência de "estranheza" (76,6%) e "medo" (72,7%). Conclusão: Em posse dos resultados observados, o cirurgião deverá considerar para a decisão de utilizar drenos após manipulação axilar em cirurgias mamárias, de um lado, o manejo de serosidades e, de outro, as dificuldades diárias e os sentimentos negativos vivenciados pelos pacientes com a utilização desses sistemas de drenagem.
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