scholarly journals Active versus passive drainage after modified radical mastectomy in breast cancer

2018 ◽  
Vol 5 (7) ◽  
pp. 2616
Author(s):  
Alex Oommen ◽  
Thara Augustine ◽  
E. V. Gopi
Keyword(s):  
Breast Cancer ◽  
Hospital Stay ◽  
Radical Mastectomy ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Suction Drain ◽  
Drain Removal ◽  
Significant Difference ◽  
Operative Drainage ◽  
Negative Suction

Background: Active drains are routinely used after Modified Radical Mastectomy (MRM) and is an important factor contributing to increased hospital stay as the patients are often discharged only after their removal. Amongst various factors that influence the amount of post operative drainage, the negative suction pressure applied to the drain has been reported to be of great significance. Against this background a study was conducted to compare the amount and duration of drainage between suction and dependent drainage in patients following Modified Radical Mastectomy.Methods: Patients were randomised using randomly ordered sealed envelopes, which were opened immediately before the closure of the wound, to decide on whether suction or dependent drain was to be given. Drains were removed when output was less than 30 ml per day. Patients were followed up from the day of surgery till the day of drain removal. Statistical analysis was performed with SPSS.Results: There is significant increase in the drain per day in post MRM patients with active suction drain. But, there is no relation between the type of drain and either total drain output or the total number of days of drain. The study also revealed that there is no significant difference in the number of days of hospital stay in both groups of patients.Conclusions: Suction drains do not have any significant advantage over dependent drains after Modified Radical Mastectomy in breast cancer patients.

scholarly journals Comparison of the Effectiveness of Full Negative Pressure with Half Negative Pressure on Suction Drain in Reducing Post-Modified Radical Mastectomy Seroma

2019 ◽  
Vol 2 (2) ◽  
pp. 24-31
Author(s):  
Gulraj Singh ◽  
Mulawan Umar ◽  
Nur Qodir
Keyword(s):  
Breast Cancer ◽  
Negative Pressure ◽  
Radical Mastectomy ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Pressure Groups ◽  
Suction Drain ◽  
Significant Difference ◽  
June July

Abstract Introduction: Modified radical mastectomy (MRM) is a breast cancer treatment option that is still operable. One of the postoperative complications that can be found is the formation of seroma. High negative suction drain is done to treat seroma after surgery but it can contribute to increase the length of stay in hospital. Methods: This study was a clinical randomized control trial (cRCT) conducted on 30 breast cancer patients in June - July 2019 at Moehammad Hoesin Hospital in Palembang. This study divided the two sample groups, each group consisting of 15 patients. One group was given half negative pressure on suction drain (experimental group) and the other used full negative pressure on suction drain (control group). Results: There was a significant difference (p <0.005) between the full and half negative pressure groups where there were more seroma events in the full vacuum group in 9 (60%) cases and half vacuum in 2 (30%) but there were no significant differences in long period of stay (p> 0.005). Conclusion: Half negative pressure is more effective in treating seroma than full negative pressure.

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

2021 ◽  
Vol 8 (9) ◽  
pp. 2544
Author(s):  
Ayman A. Albatanony ◽  
Ahmed M. A. Assar ◽  
Mohammed A. E. El Balshy
Keyword(s):  
Breast Cancer ◽  
Tranexamic Acid ◽  
General Anesthesia ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Drain Removal ◽  
Group I ◽  
Significant Difference

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.

scholarly journals The Implication of Mastectomy Flap Fixation in Decreasing the Incidence of Seroma on Breast Cancer Patient

2021 ◽  
Vol 57 (4) ◽  
pp. 277
Author(s):  
Patric Christ Ardhika Kustono ◽  
Heru Purwanto
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Radical Mastectomy ◽  
Prospective Clinical Study ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Chi Square ◽  
Significance Level ◽  
Drain Removal ◽  
Flap Fixation

Highlight: Modification of radical mastectomy with flap fixation treatment in seroma production in breast cancer patients was analyzed.The number of seromas from the drain removal time in patients undergoing modified radical mastectomy with flap fixation was reduced. Abstract: Seroma is the most common complication after mastectomy procedure. This study was conducted to analyse the treatment of flap fixation in seroma production after modified radical mastectomy in breast cancer patients.  An interventional prospective clinical study in 35 female patients with breast cancer who underwent modified radical mastectomy with flap fixation in the period August-December 2018 and 35 patients without flap fixation through historical data of patient who underwent modified radical mastectomy in the period 2016-2017 at RSUD Dr. Soetomo Surabaya. Data of characteristic patients will be presented descriptively and analyzed statistically using the appropriate test.  The result of the statistical test using Chi Square with a 95% significance level obtained a value of p = 0.000 (p <0.05), it was said statistically that there was a significant relationship between the treatment of flap fixation and the time of releasing drain in this study. The treatment of flap fixation will reduce drainage time by <10 days. The results of the odds ratio (OR) obtained OR = 16 and CI: 95% (4.094 – 62.528) which means that the treatment of flap fixation will reduce the releasing time of the drain 16 times more effectively than not performing flap fixation. Correlation between the treatment of flap fixation and the time of releasing drain was considered to be moderately positive (Contingency Coefficient Chi Square = 0.476). There was a significant reduction in the number of seroma assessed from the time of releasing drain faster in patients who underwent modified radical mastectomy with flap fixation.

scholarly journals SP8.1.1 Ultrasonic versus electrocautery dissection in modified radical mastectomy for breast cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Amna Suliman ◽  
Ahmed Latif ◽  
Ilaria Giono ◽  
Sudeendra Doddi ◽  
MIchal Uhercik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Operative Blood Loss ◽  
Significant Difference ◽  
Operative Drainage

Abstract Aims Electrocautery (EC) remains the dominant dissection tool in modified radical mastectomy (MRM) for breast cancer. However, ultrasonic dissection devices (UDD) have emerged as popular alternatives on the basis that their mechanism of action limits tissue damage resulting in decreased blood loss, seroma formation and post-operative drainage. A systematic review and meta-analysis was performed to compare surgical outcomes for EC versus UDD in MRM surgery. Methods MEDLINE, EMBASE, PubMed and the Cochrane Database were searched and a comprehensive systematic review and meta-analysis performed according to PRISMA guidelines, comparing EC versus UDD in MRM for breast cancer. Outcomes of interest were post-operative drainage, incidence of seroma, intra-operative blood loss and operative time. Meta-analysis was performed using a random effects model to aggregate the data. Odds ratios (OR) were used as the summary statistic for dichotomous data and mean difference (MD) for continuous data. Data heterogeneity was assessed using the I2 statistic. Results Nineteen eligible peer-reviewed studies were analysed involving 1501 patients, UDD:744 EC:757. We demonstrated that in MRM, UDD significantly reduced post-operative drainage (MD = 312.26, 95% confidence interval (CI): 102.59-521.93, p = 0.004); seroma (OR = 0.51, 95% CI: 0.39-0.68, p &lt; 0.00001) and intra-operative blood loss (MD = 111.68, 95% CI: 84.56-138.8, p &lt; 0.00001) with no significant difference in operative time between the two techniques (MD = 0.32 (11.3-11.94), p = 0.96. Conclusion Using UDD in MRM for breast cancer presents significant advantages in decreasing post-operative drainage, seroma and intra-operative blood loss, without lengthening operating time compared to EC. It therefore appears favourable, however further cost-effectiveness analysis would be beneficial to guide selection.

scholarly journals Dosimetric Comparison of Three Radiotherapy Techniques in Irradiation of Left-Sided Breast Cancer Patients after Radical Mastectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jian Hu ◽  
Guang Han ◽  
Yu Lei ◽  
Ximing Xu ◽  
Wei Ge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Target Volume ◽  
Conformity Index ◽  
Breast Cancer Patients ◽  
Ipsilateral Lung ◽  
Significant Difference

Introduction. This study is aimed at evaluating the dosimetric differences among target segmented planning (TSP), conventional 9-field intensity modulated radiation therapy (9FIMRT) planning, and volumetric modulated arc therapy (VMAT) planning for postmastectomy radiotherapy of left-sided breast cancer patients. Material and Methods. Fifteen left-sided breast cancer patients who underwent radical mastectomy were enrolled. In TSP, the planning target volume (PTV) was divided into four regions (supra/infraclavicular, chest wall, external mammary region, and internal mammary region), and each individual PTV region was treated with respective fixed fields. Results. The VMAT plans showed superior to PTV dose conformity index (CI), homogeneity index (HI), protection of the ipsilateral lung, monitor units (MUs), and maximum dose (Dmax) to the contralateral breast compared with TSP and 9FIMRT plans. The TSP provided better protection for Dmean of the heart and left ventricle (p<0.05). A dose for left anterior descending artery from the three techniques had no significant difference. Compared with the 9FIMRT plans, the V5Gy (%) and V10Gy (%) for the ipsilateral lung were significantly reduced with TSP and VMAT (p<0.05). The V5Gy (%) and V10Gy (%) for the ipsilateral lung turned out to be similar between VMAT and TSP techniques. Conclusions. Our study indicates that VMAT should be a better choice of radiotherapy for left-sided breast cancer patients after radical mastectomy. If VMAT is unavailable, 9FIMRT can achieve better CI and HI values and be more MU-efficient compared with TSP; however, TSP can effectively reduce the low dose volume of the ipsilateral lungs and heart.

scholarly journals A Randomized Prospective Trial of Radical (Halsted) Mastectomy Versus Modified Radical Mastectomy in 311 Breast Cancer Patients

1983 ◽  
Vol 198 (2) ◽  
pp. 207-212 ◽  
Author(s):  
WILLIAM A. MADDOX ◽  
JOHN T. CARPENTER ◽  
HENRY L. LAWS ◽  
S. J. SOONG ◽  
GRETCHEN CLOUD ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Prospective Trial ◽  
Radical Mastectomy ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Randomized Prospective Trial

scholarly journals Development and validation of a nomogram to predict drainage duration in patients with breast cancer treated with modified radical mastectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Song Wu ◽  
Zechang Xin ◽  
Daxing Sui ◽  
Zhengli Ou ◽  
Haotian Bai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Radical Mastectomy ◽  
Postoperative Management ◽  
The Body ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Modified Radical Mastectomy ◽  
Suction Drain ◽  
Postoperative Drainage

AbstractAppropriate drainage duration is vital for the postoperative rehabilitation of patients with breast cancer (BC) undergoing modified radical mastectomy (MRM). To provide better and individualized postoperative management for these patients, this study explored independent predictors of postoperative drainage duration in patients with BC. This was a single-center retrospective cohort study. Patients diagnosed with BC and treated with MRM from May 2016 to April 2020 were randomly divided into training (n = 729) and validation (n = 243) cohorts. Univariate and multivariate Cox analyses revealed that the body mass index, serum albumin level, hypertension, number of total dissected axillary lymph nodes, and ratio of positive axillary lymph nodes were independent predictors of postoperative drainage duration in the training cohort. Based on independent predictors, a nomogram was constructed to predict the median postoperative drainage duration and the probability of retaining the suction drain during this period. This nomogram had good concordance and discrimination both in the training and validation cohorts and could effectively predict the probability of retaining the suction drain during drainage, thus assisting clinicians in predicting postoperative drainage duration and providing individualized postoperative management for patients with BC.

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