Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Shiraz Shaikh ◽  
Ambreen Munir ◽  
Shahnawaz Abro ◽  
Shahida Khatoon ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
General Surgery ◽  
Stable Condition ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
University Hospital ◽  
P Value ◽  
Modified Radical Mastectomy ◽  
Group A ◽  
Group B

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.

scholarly journals DIATHERMY INCISIONS V/S SURGICAL SCALPEL INCISIONS

2015 ◽  
Vol 22 (11) ◽  
pp. 1550-1524
Author(s):  
Khawar Saeed Jamali ◽  
Naveed Ali Khan ◽  
Muhammad Jawed ◽  
Ubedullah Shaikh
Keyword(s):  
Positive Predictive Value ◽  
General Surgery ◽  
Predictive Value ◽  
Surgical Outcome ◽  
Seroma Formation ◽  
P Value ◽  
Cross Sectional ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objectives: The objective of this study was to compare the outcome of diathermyincisions v/s surgical scalpel incisions in general surgery. Study Design: Cross sectional study.Place and Duration of Study: This study was conducted at surgical unit 7, Sindh Govt. LyariGeneral Hospital and Dow University of Health Sciences between January to December 2009.Methodology: 100 consecutive patients for elective general surgery were randomly assignedto either group A incision with cutting diathermy (n=50) or group B cold steel scalpel (n=50).Data including demographic details, hospital stay, infection rate and non-infective complicationslike swelling, bleeding, dehiscence and seroma formation were recorded in both groups tocompare the final surgical outcome compared. Results: A total of 80 patients were included inthe study, placed alternatively into two groups of 40 patients each with majority being male (n =61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients of Group Awas 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basisof Gender for the two groups, the positive predictive value for male patients of Group A and Bwas 90.09% and 89.28% respectively, but for females the positive predictive value of Group Aand B was 100% and 50% respectively. In Diathermy (Group A) total 20% patients developedcomplications and these were seroma formation (n=4, 8%), wound dehiscence (n=3, 6%) andwound infection (n=3, 6%). In Scalpel (Group B) total 26% patients developed complications(P-value=0.370) in which seromas was noted (n=5, 10%) then wound infection (n=4, 8%), thenwound bleeding (n=3, 6%) and lastly seroma formation (n=1, 2%). Hospital stays were alsoalmost similar with mean value 8.24 days in diathermy group and 10.54 days in scalpel group.No remarkable difference in demographics, characteristics and in other variables of patientswas noted. Conclusion: We conclude that no significant difference in surgical outcome ofboth groups (cutting diathermy Vs. steel scalpel). Therefore, use of either technique to createsurgical wound merely depends upon preference of surgeon.

scholarly journals COMPARATIVE STUDY OF SEROMA FORMATION IN HARMONIC SCALPEL VERSUS ELECTROCAUTERY IN POST MODIFIED RADICAL MASTECTOMY

2021 ◽  
Vol 71 (2) ◽  
pp. 451-53
Author(s):  
Muhammad Farooq Shahid ◽  
Taseer Ibrahim ◽  
Muhammad Ali Muazzam ◽  
Hummaira Chaudhry ◽  
Usman Shah Bukhari ◽  
...  
Keyword(s):  
Harmonic Scalpel ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Military Hospital ◽  
Modified Radical Mastectomy ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Surgery Department ◽  
Mean Time

Objective: To compare the frequency of seroma formation in harmonic scalpel vsunipolar electrocautery in post modified radical mastectomy (MRM). Study Design: Quasi experimental study. Place and Duration of Study: General Surgery Department, Pak Emirates Military Hospital Rawalpindi, from Jul to Dec 2017. Methodology: Eighty women with breast carcinoma planned for modified radical mastectomy were included in the study with inclusion and exclusion criteria and divided in equal group A (Harmonic) and group B (Unipolar cautery). Randomization was performed by lottery method for both groups. A standard level III clearance was performed. All patients were followed up on weekly basis and seroma formation was evaluated in both groups. Results: Mean age in group A and B was 51.36 ± 11.04 years vs 52 ± 11.19 years (p>0.05). Mean duration of complain in group A and B was 1.675 ± 0.47 months vs 1.775 ± 0.42 (p>0.05). Mean time of procedure in group A and B was 110.00 ± 4.71 mins vs 100.875 ± 5.14 (p>0.05). Mean body mass index in group A and B was 30.217 ± 4.99 kg/m2 vs 30.210 ± 5.31 kg/m2 (p>0.05). Seroma formation in group A and group B patients were found to be 5 (12.5%) vs 10 (25%) with (p>0.05). Conclusion: Frequency of seroma formation in harmonic scalpel is lower than electrocautery in post modified radical mastectomy, so it can be safely performed along with harmonic scalpel with reduced duration of drainage and seroma formation.

scholarly journals Comparison of Axillary Exclusion Versus no Exclusion on Seroma Formation after Modified Radical Mastectomy

2021 ◽  
Vol 15 (1) ◽  
pp. 32-35
Author(s):  
Soofia Irfan ◽  
◽  
Muhammad Yaqoob ◽  
Sajid Rehman Randhawa ◽  
Muhammad Faisal Bilal Lodhi ◽  
...  
Keyword(s):  
Radical Mastectomy ◽  
Ethical Review ◽  
Common Side Effect ◽  
Axillary Lymph Nodes ◽  
P Value ◽  
Axillary Lymph ◽  
Modified Radical Mastectomy ◽  
Prolonged Stay ◽  
Group A ◽  
Group B

Background: Accumulation of seroma in axilla and under mastectomy flaps is a common side effect after axillary lymph nodes dissection in mastectomy, which requires repeated aspirations and prolonged stay of the drain causing discomfort to person. Objective: To determine the effectiveness of axillary exclusion technique versus no axillary exclusion in Modified Radical Mastectomy in terms of mean drain output. Study Design: Randomized control trial. Settings: The study was conducted in department of Surgery, Allied Hospital Faisalabad Pakistan. Duration: 1 year from August 08, 2018 to August 07, 2019. Methodology: After permission from Hospital Ethical Review Committee, 60 Patients presenting for mastectomy were included in the study. They were randomly divided into two equal groups of 30 patients each applying computer generated random number table. Group A (underwent axillary exclusion) and Group B (did not undergo axillary exclusion) after modified radical mastectomy. Total amount of fluid collected in drain bag postoperatively was noted till the removal of drain and compared between the groups. Data was entered in a pre-designed proforma. Results: Comparison of axillary exclusion technique with no exclusion after modified radical mastectomy was done, it showed that the mean of the total drain output (+SD) in Group A was 1112.4ml (+66.78) whereas mean output in Group-B was 2184ml (+117.06). (Table No.1). p-value was <0.001 showing a considerable decrease in the total volume of the seroma fluid drained between the two groups. Conclusion: Study concluded that the axillary exclusion technique significantly reduces drain output in patients following modified radical mastectomy as compared to those who do not undergo axillary exclusion.

Comparison between Scissors and Electrocautery in Seroma Formation Following Modified Radical Mastectomy (MRM)

2020 ◽  
Vol 23 (2) ◽  
pp. 87-89
Author(s):  
Hasnat Zaman Zim ◽  
SM Amjad Hossain ◽  
Abul Bashar Mohammad Khurshid Alam ◽  
Samia Shihab Uddin
Keyword(s):  
Axillary Dissection ◽  
Skin Flap ◽  
Tertiary Care ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Modified Radical Mastectomy ◽  
Chi Square ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background and Objective: Seroma is encountered as the commonest complication after mastectomy. Though various factors are suspected in causation of seroma, in this prospective study we tried to evaluate role of two different surgical technique of MRM in causation of seroma formation. Materials and Methods: In this observational comparative study, a total 90 patient of early breast carcinoma who had undergone Modified Radical Mastectomy (MRM) in 3 tertiary care hospitals of Dhaka were divided into 2 groups. In Group A, we used electrocautery for raising the skin flap and axillary dissection while in Group B we used curved Metzenbaum scissors to raise the skin flap along with aid of suture ligation for axillary dissection. Incidence of seroma formation was compared in both the groups. Results: Incidence of seroma was significantly higher with use of electrocautery. Results in both the groups were compared by Chi-square method, and statistically significant difference in incidence of seroma formation was found between two groups. Conclusion: Breast surgery, as MRM does not support injudicious use of electrocautery. Journal of Surgical Sciences (2019) Vol. 23(2): 87-89

scholarly journals Tramadol as an adjunct to bupivacaine for brachial plexus block.

2019 ◽  
Vol 26 (09) ◽  
pp. 1482-1486
Author(s):  
Afifa Zahoor ◽  
Ranna Mussrat ◽  
Muhammad Ahmad Khan ◽  
Shakeel Ahmad
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
University Hospital ◽  
Orthopedic Procedures ◽  
Controlled Study ◽  
P Value ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B ◽  
Plexus Block

Objectives: To compare the efficacy of tramadol and 0.25% bupivacaine versus 0.25% bupivacaine alone for brachial plexus block. Study Design: Randomized controlled study. Setting: Orthopedic department of Nishtar Medical University/Hospital Multan. Period: The study duration was Jan-2018 to Aug-2018. Material and Methods: 148 patients planned for with upper limb orthopedic procedures under BPB in the department of orthopedics department Nishtar Hospital Multan were included in this analysis. To Patients were randomly divided into two equal groups by lottery method. Group A patients were given solution with 38 ml 0.25% bupivacaine with 100 mg tramadol 2 ml and group B were given solution with 38 ml 0.25% bupivacaine and 2 ml 0.9 % normal saline. Time of onset of block and its duration and need for rescue analgesics were noted. Results: Time of onset of block was 14.56+1.01 minutes in group A versus 15.96+1.64 minutes in group B (p-value <0.001). Mean analgesia duration was 355.85+42.18 minutes in group A versus 310.47+38.79 minutes in group B (p-value <0.001). There were 51 (68.9%) patients in group A who required rescue analgesia and 68 (91.9%) patients in group B required rescue analgesia (p-value 0.004). Conclusion: We concluded that the addition of tramadol as adjunct to bupivacaine for BPB significantly shortens the duration of onset, prolongs the duration of analgesia and reduces the need for rescue analgesics.

Comparison of Efficacy of I/V Tramadol and Bupivacaine Irrigation through Drains after Modified Radical Mastectomy

2021 ◽  
Vol 15 (11) ◽  
pp. 3007-3011
Author(s):  
Zarqa Rani ◽  
Iqra Mushtaq ◽  
Mehreen Akram ◽  
Zahra Ishrat
Keyword(s):  
Breast Cancer ◽  
Urinary Retention ◽  
Controlled Trial ◽  
Radical Mastectomy ◽  
Breast Cancer Surgery ◽  
Modified Radical Mastectomy ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Severe postsurgical pain continues to be hard to manage in patients who experience breast cancer surgery. Badly managed pain can lead to meager patient satisfaction, prolonged hospital stay, and increased risk of complication by analgesics, and may be a reason in the development of long-lasting pain. Aim: To compare the efficacy of Intravenous Tramadol and Bupivacaine irrigation through surgical drains after Modified Radical Mastectomy in patients with carcinoma breast. Methods: This was a randomized controlled trial conducted in the Department of Anesthesia, Mayo Hospital Lahore. Total 70 female patients aged 18-70 years undergoing radical mastectomy for CA breast diagnosed on histopathology were selected. Patients were divided into two groups A and B through simple random sampling technique. Group A received intravenous Tramadol. Group B received Bupivacaine through surgical drains. Results: At 0, 2, 4 and 6 hour postoperatively no significant difference was seen in severity of pain in both treatment groups. In Group-A at 0, 2, 4 and 6 hour postoperatively, 68.8%, 71.4%, 57.1% and 60% respectively had reported no pain while in Group-B at 0, 2, 4 and 6 hour postoperatively, 48.6%, 65.7%, 45.7% and 54.3% patients had reported no pain. Complaints of Nausea, vomiting, sedation, urinary retention was higher in patients in Tramadol Group as compared to Bupivacaine Group. Conclusion: Results of this study demonstrated that bupivacaine administrated through surgical drain was equally effective as intravenous tramadol for controlling postoperative mastectomy pain with less side effects. Keyword: Breast Cancer, Acute Pain, Analgesia, Tramadol, Bupivacaine, Radical Mastectomy, Nausea, Vomiting, Sedation, Urinary retention, Hypotension

scholarly journals Outcome of thyroid lobectomies undergone with and without drains

2020 ◽  
Vol 8 (8) ◽  
pp. 2919
Author(s):  
Sahrish Bachani ◽  
Shahid N. Memon ◽  
Muhammad R. Pathan ◽  
Rehmat Sehrish Shah ◽  
Aneeta Kumari ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Pain Score ◽  
Thyroid Nodules ◽  
University Hospital ◽  
P Value ◽  
Thyroid Lobectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Thyroid lobectomy is a common operative technique of management of benign solitary thyroid nodules in which drains are used routinely. Objective of this study to compare the outcome of thyroid lobectomies undergone with and without drains in patients of benign solitary thyroid nodules.Methods: A comparative cross-sectional research was completed on 98 patients of benign solitary thyroid nodules at surgery department of Liaquat University Hospital Jamshoro. Patients having age of 18-60 years underwent thyroid lobectomies were included and distributed in two groups A and B. Group A includes thyroid lobectomies with drain and Group B without drain. Postoperative outcomes including pain score assessed via visual analog score (VAS), hospital stay and complications including wound infection, seroma and hematoma.Results: Out of 98 cases, 49 underwent thyroid lobectomy with drain and 49 without a drain. Females patients were in majority in group A 42 (85.7%) and also in group B 47 (95.9%). No significant difference (p-value=0.674) was in mean age of group A 30.8±10.2 years and group B 31.8±12.2 years. Higher mean with significant difference (p-value=0.001) was in pain score of group A 5.61±1.25 as compared to group B 3.55±0.70. No significant difference was in complications; seroma 1 (2.04%) vs 5 (10.20%), hematoma 1 (2.04%) vs 1 (2.04%) and infection 3 (6.12%) vs 0 (0.0%) in group A and B respectively. Higher mean with significant difference (p-value=0.001) was in hospital stay of group A 2.40±1.57 days as compared to group B 1.42±0.54 days. No significant difference (p-value=0.748) was in overall rate of complications in group A 5 (10.20%) and B 6 (12.24%).Conclusions: Thyroid lobectomy with drain is not effective in lowering the postoperative complications whereas enhanced the risk of postoperative pain, wound infection and duration of hospital stay as compared to thyroid lobectomy without a drain.

Frequency of Early Post-Operative Complications following Modified Radical Mastectomy (MRM) in patients with Breast Carcinoma

2021 ◽  
Vol 15 (6) ◽  
pp. 1623-1625
Author(s):  
Sadia Shah ◽  
Rahmat Ullah Shah ◽  
Adnan Badar ◽  
Monawar Shah ◽  
Shabir Ahmad ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Wound Infection ◽  
Skin Flap ◽  
Radical Mastectomy ◽  
Wound Dehiscence ◽  
Seroma Formation ◽  
Flap Necrosis ◽  
Modified Radical Mastectomy ◽  
Operative Complications ◽  
Post Operative Complications

Objective: Breast carcinoma is the commonest cancer affecting female gender and is the second major cause of mortality in females globally. Among different surgical options, modified radical mastectomy (MRM) with or without neoadjuvant therapy is the most frequent surgery carried out globally for breast carcinoma. In this study we aimed to determine the frequency of early post-operative complications following modified radical mastectomy (MRM) in patients with breast carcinoma. Material and methods: This dual setting retrospective descriptive study was conducted at General surgery departments of Kuwait Teaching Hospital and MTI-Lady Reading Hospital Peshawar between January, 2018 and June, 2019. A total of 60 patients aged >18 years with biopsy proven stage-I to stage-III breast carcinoma who underwent modified radical mastectomy were included.All patients were followed on weekly basis for six weeks at the out-patient department (OPD) and evaluated for the development of early complications such as seroma/hematoma, flap necrosis and wound infections. Results: Seroma formation found in 9 patients (15%) and wound infection seen in 5 patients (8.3%) were the commonest complications. Conclusion: In our study seroma formation was the most common complication followed by wound infection. Skin flap necrosis, wound dehiscence, hematoma formation and development of early lymphoedema were less common. None of our patients presented with muscle paralysis secondary to nerves injury. Keywords: Breast carcinoma, modified radical mastectomy, complications, seroma, wound infection.

scholarly journals Assessment of the Efficacy of Nebulized 3% Hypertonic Saline versus Nebulized Adrenaline in Infants with Acute Bronchiolitis

2021 ◽  
pp. 43-54
Author(s):  
Nancy Elsayed Abdel Gawad Elkhateeb ◽  
Mohamed Bassiony Hamza ◽  
Rasha Mohamed Gamal El Shafiey ◽  
Ahmed Mohamed Abdel- Razik
Keyword(s):  
Hypertonic Saline ◽  
Conventional Therapy ◽  
Supportive Therapy ◽  
University Hospital ◽  
P Value ◽  
Acute Bronchiolitis ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Length Of Hospitalization

Aims: The aim of the work was to assess the efficacy of nebulized 3% hypertonic saline versus nebulized adrenaline in treatment of acute bronchiolitis in infants as supportive therapy with conventional therapy. Place and Duration of Study: Pediatric Pulmonology Unit (PPU), Tanta University Hospital (TUH), was applied during the period from April 2019 to April 2020. Methodology: We included ninety infants with moderate to severe acute bronchiolitis were selected, enrolled in the study and randomized into 3 groups: Group A: thirty patients were received nebulized 3% hypertonic saline plus conventional therapy. Was started from first day of admission till RADI score became 4. Group B: thirty patients were received nebulized adrenaline plus conventional therapy. Was started from first day of admission till RADI score became 4. Group C: thirty patients were received conventional therapy. Was started from first day of admission till RADI score became 4. They were subjected to history taking, clinical assessment and investigations (CXR, ECHO, CBC and CRP). Follow up done in Chest Clinic four day after discharge. Results: There was statistically significant difference between studied groups as mean duration of O2 supplementation was significantly shorter in group B than in  group  A than in group C (p-value<0.05). On admission, mean RR in group B was significantly higher than those in groups A and C (p-value=0.05), On 5th day, mean RR in group B was significantly lower than those in groups A and C (p-value= 0.05). On admission, mean HR in group B was significantly higher than those in groups A and c (p-value =0.05) On 5th days, mean HR in group B was significantly lower than those in groups A and C (p-value= 0.05), with no statistically significant difference between groups A and C. length of hospitalization in studied groups group B showed significantly shorter need for hospital stay than that in groups A and C, with no statistically significant difference between group A and C. Conclusion: When comparing between inhalation of adrenaline and hypertonic saline 3% in acute bronchiolitis adrenaline improve RD, oxygenation and decrease length of hospitalization.

scholarly journals Thoracic fascial planes blocks in operative bed of modified radical mastectomy and their role in alleviating post-mastectomy pain: a prospective randomized study

2021 ◽  
Vol 9 (1) ◽  
pp. 6
Author(s):  
Mohamed F. Abdelhalim ◽  
Mohamed A. Elbegawy
Keyword(s):  
Breast Surgery ◽  
Randomized Study ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Pain Scores ◽  
Lower Pain ◽  
Group A ◽  
Metastatic Activity ◽  
Group B ◽  
Better Than

Background: Proper pain management after modified radical mastectomy is crucial for improving postoperative outcomes, reducing tumor recurrence, enhancing anti-metastatic activity and achieving excellent patient`s satisfaction. Thoracic fascial planes (TFP) blocks are novel, and safe analgesia modalities to control postmastectomy pain. This study was designed to assess the efficacy and safety of intraoperative TFP blocks for providing postoperative analgesia after modified radical mastectomy.Methods: During the period from March 2020 to April 2021, 30 females (ages 25–67 years) were scheduled for elective MRM and selected randomly to one of two groups; group-A included 15 patients who underwent MRM and anesthetized with both general anesthesia and regional anesthesia (TFP blocks), group-B included 15 patients who underwent MRM and anesthetized with only general anesthesia.Results: The group-A had statistically significantly lower pain scores. The time of first rescue nalbuphine dose post-operatively was statistically significantly longer in group-A compared to group-B. The total 24h nalbuphine consumption and postoperative non-steroidal ketorolac requirements/48h were significantly lower in group-A compared to group-B. Satisfaction score in group-A was statistically significantly better than that in group-B.Conclusions: Intraoperative thoracic fascial planes blocks are simple, safe, and highly effective analgesic modalities after breast surgery.

Sign in / Sign up

Export Citation Format

Share Document