Seroma formation after axillary lymphadenectomy with and without the use of drains

Soon, Patsy; Clark, J. Madison; Magarey, Christopher

doi:10.1016/j.breast.2004.09.011

Cited by 45 publications

(43 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 reviews [2,4] each included 6 studies [10,12,13,15,35,36,37,38,39], with 3 studies reviewed in both reviews [12,13,36]. He et al [4] also reported the number of seroma aspirations.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Should a Drain Be Placed in Early Breast Cancer Surgery?

et al. 2014

View full text Add to dashboard Cite

Background: The current surgical debate has led to a reduction in the extent of surgery performed and thereby to a reduced occurrence of surgical trauma and, over the recent years, reduced seroma formation. This reduction in surgical procedures calls the need for a drain into question. Method: Using Google Scholar and the National Library of Medicine (PubMed), a literature review was performed on systematic reviews and meta-analyses regarding breast cancer surgery ± axillary dissection. Additionally, randomized trials for the time period after the last systematic review were included and evaluated according to the Jadad score. Results: The search returned 5 systematic reviews, in which a total of 1,075 patients were included (537 cases and 538 controls). Since the last review, no prospective randomized trial meeting the inclusion criteria has been published. The current reviews conclude that insertion of a drain is associated with a longer hospital stay and reduced seroma formation. The data regarding wound infection and drain insertion is inconclusive. The omission of a drain is associated with early discharge, reduced postsurgical pain, and early mobilization, but also with an increase in out-patient seroma aspirations. Conclusion: The omission of a drain is possible in early breast cancer surgery (wide local excision and sentinel node biopsy) with adequate surgical techniques and instruments.

show abstract

“…2 reviews [2,4] each included 6 studies [10,12,13,15,35,36,37,38,39], with 3 studies reviewed in both reviews [12,13,36]. He et al [4] also reported the number of seroma aspirations.…”

Section: Resultsmentioning

confidence: 99%

“…3 studies did compare short-term versus volume-controlled removal of the drain [10,37,39]. He et al [4] report on 5 trials [12,13,15,37,38], with 3 of them using a definition of infection. Both reviews report no correlation for the infection rate.…”

Section: Resultsmentioning

confidence: 99%

Should a Drain Be Placed in Early Breast Cancer Surgery?

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Six RCTs involving 585 patients met inclusion criteria [22][23][24][25][26][27]. Among them, 297 patients were randomized to drainage group and 288 patients to no drainage group.…”

Section: Description Of Eligible Trialsmentioning

confidence: 99%

“…Among them, 297 patients were randomized to drainage group and 288 patients to no drainage group. The eligibility criteria of the patient were fully detailed in all six included trials [22][23][24][25][26][27], but the excluded criteria were described in only three of the trials [25][26][27]. Five of the trials were inserted a single suction drain into the axilla after ANLD, in which one trial applied axillary padding to no drainage group [27].…”

Section: Description Of Eligible Trialsmentioning

confidence: 99%

See 1 more Smart Citation

Whether drainage should be used after surgery for breast cancer? A systematic review of randomized controlled trials

Guo

Tian

et al. 2010

Med Oncol

View full text Add to dashboard Cite

A systematic review of randomized controlled trials (RCTs) was conducted to evaluate whether patients benefit from the suction drainage after axillary lymph node dissection (ALND) in breast cancer surgery. RCTs of drainage versus no drainage after ALND in women with breast cancer were retrieved from PubMed, EMBASE, Cochrane Library and Chinese Biomedical database. Two authors independently assessed the quality of included trials and extracted data. Odds ratio (OR) for dichotomous outcomes and mean difference (MD) for continuous outcomes were presented with 95% confidence intervals (CI). A total of 1115 titles were indentified from the databases; 1109 obvious irrelevant studies were excluded by examining the titles, abstracts, full texts because of duplicates, no RCT, different modality of drainage, drain for lymphedema, application of fibrin sealant and so on. And then, only 6 RCTs to compare drainage with no drainage after ALND in breast cancer surgery were included in the systematic review and a total of 585 patients were included in the pathological diagnosis of breast cancer in women before surgery, management by ALND with or without addition surgical procedures. The study demonstrated that insertion of a drain in the axilla after breast cancer surgery resulted in a statistically significant reduction in the rate of seroma (OR = 0.36, 95% CI, 0.16 to 0.81, P = 0.01), the volume of aspiration (MD = -100.10, 95% CI, -174.36 to -25.85, P = 0.008), or the frequency of seroma aspiration (MD = -1.03, 95% CI, -1.35 to -0.71, P < 0.00001), but prolonged the length of hospital stay (MD = 1.52, 95% CI, 0.36 to 2.68, P = 0.01). There was no statistically significant difference in the incidence of wound infection (OR = 0.67, 95% CI, 0.34 to 1.32, P = 0.25) between drainage group and no drainage group. Based on the current evidence, insertion of a drain in the axilla following ALND in breast cancer surgery effectively decreased seroma formation, volume of aspiration as well as the frequency of seroma aspiration without increasing the incidence of wound infection, but extending their stay in hospital.

show abstract