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 Frequency of early post operative complications of modified radical mastectomy within period of four weeks

2020 ◽  
Vol 8 (5) ◽  
pp. 1838
Author(s):  
Rekha Melwani ◽  
Sadaf Jabeen Malik ◽  
Sobohi Shakeel ◽  
Shahid Zafar ◽  
Muhammad Yousif Khoso ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Wound Infection ◽  
Radical Mastectomy ◽  
Care Hospital ◽  
Modified Radical Mastectomy ◽  
Shoulder Dysfunction ◽  
Number Of Patients ◽  
Increased Risk ◽  
Operative Complications ◽  
Post Operative Complications

Background: Most of the complications are developed after modified radical mastectomy in breast cancer patients, hence to avoid and reduces the postoperative complications, this study is performed to identify the frequency of early post-operative complications of modified Radical Mastectomy within the period of four weeks.Methods: Cross-sectional case series using non-probability convenient sampling technique was conducted in surgical unit I of Tertiary care hospital, for 1 year from 15 January 2018 to 14 January 2019. 89 patients FNAC proved breast cancer were included, patients that received neoadjuvant chemo or radiotherapy or with inflammatory breast cancer, metastasis and with co-morbid were excluded. After taking consent patients were operated by senior consultant. Follow up was taken daily 7th post-operative day and then followed in OPD on weekly basis fourth week and final outcome was noted. SPSS version 23 was used for data analysis. Quantitative data was reported as frequency in percentages.Results: Total 31 patients developed complications during the study, accounts 34% of total patients. The most common complication was breast seroma in 12(13.48%) of cases with an increased risk in cases of age >50 yr, size of tumor >8 cm, weight >70 kg and increased number of lymph nodes [3 or above] palpable after wards hematoma in 6(6.74%), lymphedema in 5(5.62%), wound infection 4(4.49%) and shoulder dysfunction in 4(4.49%) patients, no patient was found scar hypertrophy.Conclusions: Seroma formation, hematoma were found most common early complications after modified radical mastectomy, lymphedema, wound infection and shoulder dysfunction were observed in small number of patients.

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.

Comparison of Post-Operative Complications Between Sublay and Onlay Mesh Repair in Incisional Hernia

2021 ◽  
Vol 15 (12) ◽  
pp. 3384-3386
Author(s):  
Azizullah Khan Sherani ◽  
Saleem Javed ◽  
Muhammad Idrees Achackzai
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Seroma Formation ◽  
Onlay Technique ◽  
Sublay Technique ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Objective: To compare the post-operative complications between sublay and onlay mesh repair in incisional hernia. Materials & Methods: This randomized controlled trial was conducted at Department of Surgery, Sandeman Provincial Hospital Quetta from May 2019 to November 2019. Total 250 patients with incisional hernias for more than 3 months, having age 20-40 years either male or female were selected. Then selected patients were placed randomly into two groups i.e. Group A (Sublay group) & Group B (Onlay group), by using lottery method. Patients were called for follow up 15th day for post-operative complications in term of wound infection and seroma formation. Results: The mean age of patients in group A was 34.73 ± 4.32 years and in group B was 34.51 ± 4.67 years. Out of these 250 patients, 161 (64.40%) were female and 89 (35.60%) were males with female to male ratio of 1.8:1. Wound infection was seen in 07 (5.60%) patients in group A (Sublay technique) and 17 (13.60%) patients in group B (Onlay technique) with p-value of 0.033. Seroma formation was seen in 09 (7.20%) patients in group A (Sublay technique) and 26 (20.80%) patients in group B (Onlay technique) with p-value of 0.002. Conclusion: This study concluded that rate of wound infection and seroma formation is less after sublay mesh repair for incisional hernia as compared to onlay repair. Keywords: Hernia, incisional, onlay, sublay, seroma.

scholarly journals A randomized controlled trial evaluating the efficacy of mastectomy flap quilting sutures in reducing post modified radical mastectomy seroma formation

2017 ◽  
Vol 4 (2) ◽  
pp. 714
Author(s):  
Madhu B. S. ◽  
Naveen Kumar Reddy M. ◽  
Shashi Kumar H. B. ◽  
Sangeetha Kalabairav ◽  
Abilash V. Reddy ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Skin Flap ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Control Group ◽  
Study Group ◽  
Modified Radical Mastectomy ◽  
Related Factors ◽  
Absorbable Sutures ◽  
Mastectomy Flap

Background: One of the most common complication post modified radical mastectomy is the formation of seroma. Seroma formation in-turn delays wound healing, increases susceptibility to infection, skin flap necrosis, persistent pain and thus prolongs convalescence. For this, several techniques have been tried and trialed to improve primary healing and decrease the formation of seroma.Methods: Between Aug 2014 and July 2016, 60 patients with carcinoma of the breast, posted for modified radical mastectomy at KR Hospital, Mysuru, Karnataka, India were randomly divided into 2 groups, the study group (30) and the control group (30). In the study group; the mastectomy flap quilting sutures were put between the flap and the pectoral fascia and muscle at different parts of the flap and at the flap edge with absorbable sutures (polyglactin 3-0). In the control group; the flaps were approximated by the conventional method at the edges. Closed suction drains were placed in both the groups. Patients, tumour characteristics and operative related factors were documented. The volume and colour of the fluid drained was recorded everyday. The drains were removed when the amount became less than 30 cc in a 24 hour period. The total volume and duration (number of days) of fluid drained and the complications were recorded and compared.Results: In the study group, the drain was removed much earlier when compared to the control group (p < 0.001). The total amount of fluid drained was much lower in the study group (p < 0.001). The study group showed a much lower frequency of seroma formation when compared to the control group.Conclusions: The mastectomy quilting suture technique is an effective procedure that considerably reduces the incidence of seroma formation in patients undergoing modified radical mastectomy.

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 Comparison of post-operative complications in modified radical mastectomy patients with full suction and compression bandage versus half suction and non-compression bandage

2020 ◽  
Vol 7 (5) ◽  
pp. 1541
Author(s):  
Mohammad Athar ◽  
Sanjay Kala ◽  
Abhineet Gupta ◽  
Ashish Varshney
Keyword(s):  
Hospital Stay ◽  
Skin Flap ◽  
Length Of Hospital Stay ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Flap Necrosis ◽  
Suction Drainage ◽  
Superficial Skin ◽  
Group 2 ◽  
Group 1

Background: Modified radical mastectomy still remains the most common surgical procedure employed in definitive management of breast cancer. Post mastectomy problems include skin flap necrosis, prolonged axillary drainage, seroma formation, wound gaping etc., among all seroma is commonest. Drainage usage and dressing applied after this procedure is debatable due to varying recommendations.Methods: A prospective randomized control trial was conducted on 84 FNAC/TRUECUT biopsy proven cases of early and locally advanced breast cancer patients admitted in surgery department, GSVM Medical College, Kanpur over a period of two years. Aiming to compare full suction drainage and compression dressing (n=42) (group 1) with half suction drainage and non-compression dressing (n=34) (group 2), in terms of post-operative morbidities like skin flap necrosis, prolonged axillary drainage, seroma formation, wound gaping and length of hospital stay. Romsons 16 number Romovac drains were used for suction and 2 elastic 6” crape bandage were used for compression.Results: During follow-up there was significant lower incidence of seroma formation in group 1 patients compared to group 2 patients (p<0.0019). Full compression dressing patients have increased incidence of superficial skin necrosis compared to non-compression dressing patients (p<0.022). Patients with half suction drainage and non-compression dressing has early drain removal than patients with full suction drainage and compression dressing (p<0.05), the length of hospital stay was less in group 2 compared to group 1.Conclusions: There is markedly lesser incidence of post-operative seroma formation along with reduced morbidity in the form of patients discomfort and flap necrosis in post MRM patients with full suction drainage and compression dressing, but it requires a greater hospital stay and has slightly higher risk of superficial skin necrosis which can be easily managed with topical ointments, compared to patients with half suction drainage and non-compression dressing.

scholarly journals Comparison of electrocautery and plasmablade on ischemia and seroma formation after modified radical mastectomy for locally advanced breast cancer

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Husnu Alptekin ◽  
Huseyin Yılmaz ◽  
Bahadir Ozturk ◽  
Ilhan Ece ◽  
Mehmet Ertugrul Kafali ◽  
...  
Keyword(s):  
Locally Advanced Breast Cancer ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Modified Radical Mastectomy ◽  
Drainage Volume ◽  
Drain Removal ◽  
Postoperative Drainage ◽  
The Mean

The aim of this study was to compare postoperative drainage volumes and IMA levels in patients who underwent modified radical mastectomy (MRM) with using PlasmaBlade (PB) or electrocautery (EC). A total of 36 patients who underwent MRM with PB or EC in our clinic between August 2012 to February 2013 were enrolled. Number of removed and positive lymph nodes, duration of drainage and total drainage volume was recorded. Seroma formation after drain removal and number of aspirations were also recorded. Serum ischemia modified albümine (IMA) levels were analysed before surgery, 1 hour and 24 hour after surgery. In total, 36 patients were treated with MRM in the study period. Of the 36 patients, 16 underwent MRM with PB, and 20 underwent MRM with EC. The patients demographics were similar in both groups. The mean drainage volume and seroma formation were significantly higher in the PB group when compared with EC group (P<0.05). Number of aspirations due to the seroma were also high in PB group. The total aspiration volume of seroma was not different in both groups. IMA levels 24 hours after surgery in the PB group was significantly higher than EC group. There was no statistical significance between the groups for IMA levels at 1st hour. PB is a monopolar energy device and is associated with increased levels of ischemia. This situation resulted with an increased volume of total axillary drainage and elevated risk of seroma formation.

scholarly journals Assessment of Pathological Response of Breast Carcinoma in Modified Radical Mastectomy Specimens after Neoadjuvant Chemotherapy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Dhanya Vasudevan ◽  
P. S. Jayalakshmy ◽  
Suresh Kumar ◽  
Siji Mathew
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Tumor Response ◽  
Ductal Carcinoma ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Tumor Characteristics ◽  
Modified Radical Mastectomy ◽  
Tumor Bed

Aim. Paclitaxel based neoadjuvant chemotherapy regimen (NAT) in the setting of locally advanced breast cancer (LABC) can render inoperable tumor (T4, N2/N3) resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response.Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma (n=48) were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR).Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors (2–5 cms) and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed.Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.

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