Factors that Affect Drain Indwelling Time after Breast Cancer Surgery

Uslukaya, Ömer; Türkoğlu, Ahmet; Gümüş, Metehan; Bozdağ, Zübeyir; Yılmaz, Ahmet; Gümüş, Hatice; Kaya, Şeyhmus; Gül, Mesut

doi:10.5152/tjbh.2016.3070

Cited by 7 publications

(8 citation statements)

References 34 publications

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“…Uslukaya et al reported that there was a positive correlation between the histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN) and metastatic lymph nodes (MLN) and the drain indwelling time (DIT). 19 Similarily, Eldesouky et al found that the mean duration of drainage was also lower in the study group as compared with the control group (9.85±1.66 versus 11.67±1.9 days; p<0.005); this difference was significant. 9 However, in Barwell et al study, suction drains were removed at the ward after a median of 4 days (range 1-7 days) for wide local excision of breast carcinoma and the median of suction drain removing for mastectomy with axillary dissection was about 12 days (range 10-14 days).…”

Section: Discussionsupporting

confidence: 67%

Correlation between C-reactive protein, intravenous hydrocortisone, systemic tranexamic acid and post mastectomy seroma

2021

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Background: Breast cancer is the second leading cause of death among women worldwide. Formation of a seroma most frequently occurs after mastectomy and axillary surgery. The objective was to find the correlation between the formation of post modified radical mastectomy seroma and C-reactive protein (CRP) and the effect of preoperative intravenous (IV) hydrocortisone, systemic tranexamic acid.Methods: This prospective study was conducted at Menoufia university hospital on female patients with primary operable breast cancer who were divided to two groups; each included 30 patients: group I received general anesthesia with hydrocortisone therapy (Solu-Cortef 100 mg solution once), systemic tranexamic acid (kapron 5 ml once) and group II received general anesthesia without hydrocortisone nor tranexamic acid. CRP serum levels before surgery and 24 hour after the procedure. All patients were followed up postoperatively for registration of the total drainage volume until drain removal, timing of drain removal, incidence of seroma formation and management of seroma.Results: Our results revealed that a significant difference between both groups as regard CRP, the incidence of seroma, time of removing the drain and total collection of the drain in favor to those who received IV hydrocortisone and systemic tranexamic acid.Conclusions: Induction of IV hydrocortisone, systemic tranexamic acid with general anaesthesia during modified radical mastectomy (MRM) are significantly decreasing the level of CRP, the incidence of seroma, time of removing the drain and total collection of the drain.

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Section: Discussionsupporting

confidence: 67%

Correlation between C-reactive protein, intravenous hydrocortisone, systemic tranexamic acid and post mastectomy seroma

2021

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“…Our study demonstrated that neoadjuvant chemotherapy significantly increased the mean duration of surgery and the mean duration of the drain placement. These findings are in concordance with studies conducted by Gümüş et al 17 and Uslukaya et al 18 Both these studies reported increased mean duration of surgery and mean duration of drain in patients who underwent neoadjuvant chemotherapy. They also reported increased length of hospital stay with neoadjuvant chemotherapy.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of Clinicopathological Findings and Postoperative Outcomes of Modified Radical Mastectomy in a Tertiary Care Center in Lahore, Pakistan

Rahman¹,

Ahmad²,

Nazir³

et al. 2021

J Islamabad Med Dental Coll

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Background: Modified radical mastectomy (MRM) remains the mainstay of breast cancer surgery in under-developed countries like Pakistan as it reduces the morbidity and mortality associated with radical surgery. This study aims to delineate the clinicopathological findings and postoperative outcomes of patients undergoing modified radical mastectomy for breast carcinoma in a local setting.Material and Methods: This cross-sectional study was conducted in Gulab Devi hospital Lahore, Punjab Pakistan, from January 2016 to December 2019. Patients (n=70) with carcinoma breast planned for modified radical mastectomy were included in the study. Two suction drains were placed (in the axilla and under the flap) and removed when drainage was less than 30 cc in 24 hours. The patients were followed-up weekly for one month and then at monthly intervals for up to one year. Independent t-test and chi-square test were used to study associations between different variables. A P-value less than .05 was considered statistically significant.Results: The mean age of the patients was 48.43 ± 12.3 years. Most of the patients (42.86%) had stage-II, grade-I carcinoma (50%) with invasive ductal carcinoma as the most frequent histological variety (80%). Majority of the patients (n=60; 85.57%) were ER/PR positive. Mean duration of surgery was 124.8 ± 20.33 minutes, the mean duration of drains was 3.5±4.5 days, and the mean length of hospital stay was 4.67 ± 1.07 days. Most common complications of mastectomy were wound infection (23.57%) and seroma formation (20%). Six (8.57%) developed recurrence of disease in one year follow-up. Neoadjuvant chemotherapy increased the mean duration of surgery and drains placement (P<.05) but had no effect on mean hospital stay and complications associated with surgery (P>.05).Conclusions: Grade-I invasive ductal carcinoma with ER/PR positive receptor status was the most frequent variety of breast carcinoma. Neoadjuvant chemotherapy was associated with increased operative time and increased duration of drain placement.

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“…Of the articles included, three were randomized controlled trials, one was a nonrandomized controlled trial, and three were retrospective chart reviews representing a total of 1226 patients (TXA, 632 patients; control, 622 patients) (Table 1). 1–60 ( See Table, Supplemental Digital Content 6 , which shows demographic information, http://links.lww.com/PRS/G260. )…”

Section: Resultsmentioning

confidence: 99%

“The Effects of Tranexamic Acid in Breast Surgery: A Systematic Review and Meta-Analysis”

Huynh

Wong

McRae

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Tranexamic acid (TXA) is used in trauma and surgical settings. Its role in reducing postoperative blood loss in breast surgery remains unclear. The primary objective of this study was to determine the effect of TXA on postoperative blood loss in breast surgery. Methods: Searches of the PubMed, Ovid MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials databases were performed from inception to April 3, 2020. Inclusion criteria were any retrospective reviews, prospective cohort studies, and randomized controlled trials that administered TXA (topical or intravenously) in the context of breast surgery. Quality of studies were evaluated using the risk of bias in randomized trials tool and the risk of bias in nonrandomized studies of interventions tool. Data were pooled, and a meta-analysis was performed. Results: In total, seven studies were included, representing 1226 patients (TXA, 632 patients; control, 622 patients). TXA was administered as follows: topically (20 mL of 25 mg/mL TXA intraoperatively; n =258 patients), intravenously (1 to 3 g perioperatively; n = 743 patients), or both (1 to 3 g daily up to 5 days postoperatively; n = 253 patients). TXA administration reduced hematoma formation in breast surgery (risk ratio, 0.48; 95% CI, 0.32 to 0.73), with no effect on drain output (mean difference, −84.12 mL; 95% CI, −206.53 to 38.29 mL), seroma formation (risk ratio, 0.92; 95% CI, 0.60 to 1.40), or infection rates (risk ratio, 1.01; 95% CI, 0.46 to 2.21). No adverse effects were reported. Conclusion:The use of TXA in breast surgery is a safe and effective modality with low-level evidence that it reduces hematoma rates without affecting seroma rates, postoperative drain output, or infection rates.

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Factors that Affect Drain Indwelling Time after Breast Cancer Surgery

Cited by 7 publications

References 34 publications

Correlation between C-reactive protein, intravenous hydrocortisone, systemic tranexamic acid and post mastectomy seroma

Correlation between C-reactive protein, intravenous hydrocortisone, systemic tranexamic acid and post mastectomy seroma

Evaluation of Clinicopathological Findings and Postoperative Outcomes of Modified Radical Mastectomy in a Tertiary Care Center in Lahore, Pakistan

“The Effects of Tranexamic Acid in Breast Surgery: A Systematic Review and Meta-Analysis”

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