Modified radical mastectomy with axillary dissection using the electrothermal bipolar vessel sealing system
| Autor: | Haridimos Markogiannakis, George C. Zografos, Georgia Kafiri, Michael Genetzakis, Andreas Manouras, Emmanuel Lagoudianakis, George M. Filippakis, Konstantinos Filis |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors medicine.medical_treatment Blood Loss Surgical Breast Neoplasms Modified Radical Mastectomy Hematoma medicine Electrocoagulation Humans Prospective Studies Aged Surgical team business.industry Axillary Lymph Node Dissection Perioperative Equipment Design Middle Aged medicine.disease Hemostasis Surgical Surgery Lymphedema Treatment Outcome Seroma Axilla Lymph Node Excision Female business Mastectomy Radical Mastectomy Follow-Up Studies |
| Zdroj: | Archives of surgery (Chicago, Ill. : 1960). 143(6) |
| ISSN: | 1538-3644 |
| Popis: | Hypothesis The use of the electrothermal bipolar vessel sealing system is feasible, safe, and effective in modified radical mastectomy with axillary dissection in terms of lymph vessel sealing, hemostasis, and perioperative complications. Design Prospective study. Setting University surgical department. Patients Between January 1, 2003, and December 31, 2003, 60 patients with locally advanced breast cancer (T2 or T3) admitted for modified radical mastectomy with axillary dissection were included in this study. The entire procedure was performed by the same surgical team using the electrothermal bipolar vessel sealing system. Main Outcome Measures Final outcome, operative time, hospitalization stay duration, intraoperative blood loss, postoperative mastectomy and axillary drainage volume and duration, and postoperative complications (seroma, bleeding, skin burn, hematoma, lymphedema, pneumothorax, and wound infection or necrosis). Results The mean (SD) intraoperative blood loss was 45 (12) mL, and the mean (SD) operative time was 105 (7) minutes. No postoperative bleeding, seroma, hematoma, lymphedema, or other complications occurred. The mean (SD) mastectomy and axillary drainage volumes were 20 (8) and 155 (35) mL, respectively, and the mean (SD) drainage durations were 1.3 (0.2) and 2.7 (0.5) days, respectively. The mean (SD) hospital stay was 3.7 (0.6) days. Conclusions In this first report (to our knowledge) of modified radical mastectomy with axillary dissection using the electrothermal bipolar vessel sealing system, the technique was feasible, safe, and effective. The device simplified the surgical procedure, while achieving efficient lymph vessel sealing and hemostasis. Compared with historical data regarding the conventional or harmonic scalpel, this technique seems to result in reduced operative time, perioperative blood loss, drainage volume and duration, and incidence of seroma or lymphedema. Prospective randomized controlled studies are necessary to evaluate the effect of this technique on perioperative complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|