Vol. 6 (02) pp. 1942-1947 DOI: 10.21474/IJAR01/10762

EVALUATION OF MASTECTOMY FLAPS FIXATION VERSUS CONVENTIONAL METHOD IN REDUCTION OF SEROMA AFTER MODIFIED RADICAL MASTECTOMY

, and
  • General Surgery Departments, Faculty of Medicine, Zagazig University.
16 Downloads 69 Views
Crossref

Download Full Paper (PDF)

Abstract

Background: Post-operative seroma is a common complication that occurs after modified radical mastectomy, due to accumulation of fluid in the dead space between skin flaps and the underlying chest wall and axilla. The aim of this study is to evaluate the effect of fixation of flaps by suturing to the chest wall muscle on the seroma formation. Patients and Methods: Our prospective study was done in general surgery department, Zagazig University, from Jan 2016 to Nov. 2017. Included 70 female patients with breast cancer operated by modified radical mastectomy, the patients were classified in to two groups (A,B) each group 35 female patients(N=35). Group (A) operated by quilting flap fixation technique while group (B) operated by conventional method. The patients were followed up for one month and both preoperative and postoperative data are recorded, reviewed and statistically analysed for comparison between the two groups. Results: The preoperative results shows nearly similar results between the two groups regarding the age and body mass index .The breast laterality, the comorbidity (diabetes mellitus (DM), hypertension (HTN), anticoagulant drugs) and stages (T,N) shows small difference between the two groups. the post-operative results shows no significant difference in the operative time, number of Infected seroma, Haematoma and Infected wound (P˃0.05).Total amount of drained fluid (ml) ,the duration of drainage (day), Seroma post drain removal and number of seroma needed aspiration all shows significant difference between the two groups (P<0.05). Conclusion: Reduction of the dead space during modified mastectomy by suturing and fixation of the skin flaps to the chest wall is a good technique to decrease post-operative seroma.

Keywords

Article Analytics

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin 2008;58:71-96.
  2. Kumar S et al. Post-mastectomy seroma: a new look into the aetiology of an old problem. J R Coll Surg Edinb. 1995;40:292?294.
  3. Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, Saito S: Pathophysiology of seroma in breast cancer. Breast Cancer.2005; 12:288-293.
  4. Aitken DR, Minton JP: Complications associated with mastectomy. Surg Clin North Am.1983; 63:1331-1352.
  5. Barton A, Blitz M, Callahan D, et al. Early removal of postmastectomy drains is not beneficial: results from a halted randomized controlled trial. Am J Surg 2006;191:652?656.
  6. Porter KA et al. Electrocautery as a factor in seroma formation following mastectomy. Am J Surg. 1998; 176: 8?11.
  7. Ouldamer L, Caille A, Giraudeau B, et al. Quilting suture of mastectomy dead space compared with conventional closure with drain. Ann Surg Oncol. 2015;22:4233?40.
  8. Pogson CJ, Adwani A, Ebbs SR: Seroma following breast cancer surgery. Eur J Surg Oncol.2003; 29:711-717.
  9. Matsui Y, Yanagida H, Yoshida H, Imamura A, Kamiyama Y, Kodama H. Seroma with fibrous capsule formation requiring a surgical resection after a modified radical mastectomy: report of a case. Surg Today. 1998;28(6):669-672.
  10. Qvamme G, Axelsson CK, Lanng C, Mortensen M, Wegeberg B, Okholm M, et al. Randomized clinical trial of prevention of seroma formation after mastectomy by local methylprednisolone injection. Br J Surg. 2015;102(10):1195-1203.
  11. Almond LM, Khodaverdi L, Kumar B, Coveney EC. Flap anchoring following primary breast cancer surgery facilitates early hospital discharge and reduces costs. Breast Care (Basel) 2010;5: 97-101.
  12. Ten Wolde B et al. Quilting prevents seroma formation following breast cancer surgery: closing the dead space by quilting prevents seroma following axillary lymph node dissection and mastectomy. Ann Surg Oncol.2014;21:802?807.
  13. Kuroi K et al. Effect of mechanical closure of dead space on seromaformation after breast surgery. Breast Cancer. 2006;13(3):260?265.
  14. Srivastava V et al. Seroma formation after breast cancer surgery: what we have learned in the last two decades. J Breast Cancer. 2012;15(4):373?380.
  15. Kontos M, Kothari A, Hamed H (2008) Effect of harmonic scalpel on seroma formation following surgery for breast cancer: a prospective randomized study.J BUON 13: 223-230.
  16. Schuijtvlot M Sahu AN Cawthorn SJ (2002) A prospective audit of the use of a buttress suture to seroma formation following axillary node dissection without drains. Breast 11: 94-96.
  17. A. Sakkary, ?The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients,? World Journal of Surgical Oncology, vol. 10, article 8,2012.
  18. Khater A, Elnahas W, Roshdy S, Farouk O, Senbel A, et al. (2015) Evaluation of the Quilting Technique for Reduction of Postmastectomy Seroma: A Randomized Controlled Study. Int J Breast Cancer 2015: 287398.
  19. Anjani J, Amit O, Kuber S, Achal G (2016) Factors affecting seroma formation after modified radical mastectomy in patients of carcinoma breast: A prospective study. IJSS Journal of Surgery 21-5.
  20. Bemmel AJ, van de Velde CJ, Schmitz RF, Liefers GJ (2011) Prevention of seroma formation after axillary dissection in breast cancer: a systematic review.Eur J Surg Oncol 37: 829-835.
  21. Faisal M, Abu-Elela S, Mostafa W, and Antar O (2016) Efficacy of axillary exclusion on seroma formation after modified radical mastectomy. World J Surg Oncol 14: 39.
  22. Pogson CJ et al. Seroma following breast cancer surgery. Eur J Surg Oncol.2003;29:711?717.
  23. Holcombe C et al. The satisfaction and savings of early discharge with drain in situ following axillary lymphadenectomy in the treatment of breast cancer. Eur J Surg Oncol. 1995;21(6):604?606.
  24. Say CC, Donegan W (1974) A biostatistical evaluation of complications from mastectomy. Surg Gynecol Obstet 138: 370-376.
  25. Degnim AC et al. Surgical site infection (SSI) after breast surgery: impact of 2010 CDC Reporting Guidelines. Ann Surg Oncol. 2012;19(13):4099?103.
 

How to Cite This Article

Hany Mohamed, Sherif Holyl and Hatem Mohammed (2018); EVALUATION OF MASTECTOMY FLAPS FIXATION VERSUS CONVENTIONAL METHOD IN REDUCTION OF SEROMA AFTER MODIFIED RADICAL MASTECTOMY, Int. J. of Adv. Res., 6 (02), 1942-1947, ISSN 2320-5407. DOI: https://doi.org/10.21474/IJAR01/10762

Corresponding Author

Hany Mohamed

Creative Commons Attribution 4.0 This work is licensed under a Creative Commons Attribution 4.0 International License.