Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Antonio, M

doi:10.3332/ecancer.2007.61

Cited by 9 publications

(21 citation statements)

References 20 publications

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“…[25] An Italian group compared the bipolar vessel sealing system with conventional surgical dissection and found no difference in the duration of the surgical procedure, total drainage fluid volume, drainage duration, or postoperative adverse events between the groups in a randomized trial. [26] Interestingly, a significant increase in seroma was observed in the vessel sealing system group. However other studies have reported improved results with use of a vessel sealing system.…”

Section: Surgical Devicesmentioning

confidence: 92%

“…Body weight [2] and body mass index are associated with increased seroma formation, whereas no consistent association has been found between seroma formation and hormone receptor status, [26] axillary nodal status, lymph node positivity [18,20] or disease stage and grade. [18,26] Similarly, no consistent association has been found between seroma formation and the presence of anemia, smoking, diabetes mellitus, or breast size. [14] Tumor size and location, histological type, site of the disease and specimen weight are not associated with increased seroma formation.…”

Section: No Wound Drainagementioning

confidence: 99%

“…[14] Tumor size and location, histological type, site of the disease and specimen weight are not associated with increased seroma formation. [26] CONCLUSIONS: Seroma formation is a side effect of M.R.M rather than a complication but can delay patient recovery and cause unpleasant symptoms. Patient and tumor-related factors have no significant bearing on seroma formation except possibly body weight and body mass index, which seem to be directly proportional to seroma formation.…”

Section: No Wound Drainagementioning

confidence: 99%

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Seroma Formation in Cancer Breast Surgery

Sitaram¹,

Hemanthi²

2015

jemds

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Post-operative breast surgery for malignancy has a common side effect of seromas, whose formation and drainage requires a special attention to prevent as much as possible and as early as possible to avoid morbidity. How best we can prevent the dead space is the problem. In this study a review of various methods adopted all over the world is reviewed including early discharge of the patient with drain. It is always preferable to remove the drain when the collection of serum is less than 25ml in 24 hours the chance of re accumulation of fluid is less likely. INTRODUCTION: Carcinoma breast has remained the second leading cause of cancer death among women worldwide over the past three decades [1] and contributes significantly to cancer surgical load. Surgical treatment for breast cancer includes breast conservation therapy and mastectomy with or without axillary dissection depending on disease stage. Seroma formation is the most frequent postoperative Side effect seen after mastectomy and axillary surgery with an incidence of 3% to 85%. OBSERVATIONS: TYPE OF SURGERY: Surgical treatment for breast cancer has undergone a paradigm shift from Halstead's radical mastectomy to breast conservation. It has been demonstrated that radical mastectomy increases seroma formation compared with that of simple mastectomy, but the association is inconclusive when radical mastectomy is compared with modified radical mastectomy (MRM). SURGICAL DEVICES: Various electro-mechanical devices are used during surgery to reduce blood loss and operating time. These include electrocautery, laser scalpel, argon diathermy, ultrasonic scalpel, ultrasonic scissors, and vessel sealing systems. All of these devices have been investigated in an effort to reduce seroma formation. Randomized trials have shown that the use of electrocautery for dissecting flaps is significantly associated with increased seroma formation when compared to that of scalpel dissection. However, no individual study has shown a significant effect on seroma formation with or without the use of a laser scalpel, argon diathermy, or an ultrasonic scalpel. Ultrasonic scissors resulted in reduced seroma formation in a randomized controlled trial comparing level I and II axillary dissection using either ultrasound scissors or surgical scissors with ligation. MANAGEMENT OF DEAD SPACE: MECHANICAL DEVICES: Different techniques have been employed to obliterate the dead space (under flaps and the axilla) to reduce seroma formation. CHEMICAL: Fibrin glue.light activated fibrin sealant, and transdermal photo-polymerized adhesive reduce seroma formation after mastectomy in animal models. Use of a fibrinolysis inhibitor was based on the hypothesis that fibrinolytic activity in serum and lymph might contribute to fluid accumulation. SHOULDER MOVEMENT: Shoulder dysfunction is a common complication of mastectomy,and it is necessary to mobilize the shoulder early to prevent this complication. It was thought that early shoulder mobilization led to increased seroma formation and this hypot...

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Section: Surgical Devicesmentioning

confidence: 92%

Section: No Wound Drainagementioning

confidence: 99%

Section: No Wound Drainagementioning

confidence: 99%

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Seroma Formation in Cancer Breast Surgery

Sitaram¹,

Hemanthi²

2015

jemds

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“…Overall 4 studies were included [1,4,15,17]. The three of them were randomized controlled trials [1,4,15], whereas the fourth was a retrospective observational study [17].…”

Section: Included and Excluded Studiesmentioning

confidence: 99%

“…The three of them were randomized controlled trials [1,4,15], whereas the fourth was a retrospective observational study [17]. One study was excluded from the present review due to absence of a control group [14].…”

Section: Included and Excluded Studiesmentioning

confidence: 99%