Effect of Octreotide on Lymphorrhea in Patients After Modified Radical Mastectomy for Carcinoma Breast: A Randomized Controlled Trial

Prajapati, Sahaj; Ramasamy, S.; Vats, Manu; Neogi, Sushanto; Kantamaneni, Ketan; Tudu, Sanjeev Kumar

doi:10.7759/cureus.19225

Cited by 6 publications

(12 citation statements)

References 20 publications

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“…The following nine studies were then excluded: seven studies with duplicate records, one comparative study of the long- versus short-term use of octreotide (15) , and one protocol without results (16) . Ultimately, seven studies with 738 participants were considered eligible for inclusion (17) , (18) , (19) , (20) , (21) , (22) , (23) . No additional articles that met the inclusion criteria were identified from the reference lists of studies.…”

Section: Resultsmentioning

confidence: 99%

The Efficacy and Safety of Somatostatin Analog after Axillary Node Dissection in Breast Cancer: A Systematic Review and Meta-analysis

2023

JMA J

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Background: Somatostatin analogs are expected to reduce lymphatic leakage. However, whether they can be used after axillary lymphadenectomy is unclear. This study aimed to assess the efficacy and safety of somatostatin analogs in axillary lymphadenectomy for breast cancer patients. Methods: We performed a random-effects meta-analysis by searching electronic databases for randomized trials and trial registries until June 2022. The primary outcomes were the volume of drained fluid, the duration of drainage, and seroma incidence. Bias was assessed using the Cochrane Collaboration’s tool and the Grading of Recommendations, Assessment, Development, and Evaluations approach. Results: Six trials (738 participants) and one protocol without results were included. Somatostatin analogs may reduce the volume of drained fluid (mean difference = −22.07 mL, 95% confidence interval [CI] = −42.09 to −2.05; I 2 = 56%) while resulting in a slight-to-no difference in the duration of drainage (mean difference = −0.48 days, 95% CI = −1.43 to 0.46; I 2 = 87%) and seroma incidence (risk ratio = 0.91, 95% CI = 0.61-1.34; I 2 = 55%). The certainty of the evidence was low. Conclusions: There was limited evidence supporting somatostatin analogs for lymphorrhea after axillary lymphadenectomy. Multicenter randomized controlled trials are needed to confirm the efficacy and safety of somatostatin analogs after axillary lymphadenectomy.

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Section: Resultsmentioning

confidence: 99%

The Efficacy and Safety of Somatostatin Analog after Axillary Node Dissection in Breast Cancer: A Systematic Review and Meta-analysis

2023

JMA J

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“…The underlying mechanism of post-MRM seroma formation is thought to be due to the disruption of lymphatic channels and the creation of a dead space during flap elevation. Several factors are found in high concentration in seroma fluid such as IgG, granulocytes, proteinases, leukocytes, and many other cytokines [ 9 ]. There is documented evidence that corticosteroids, such as hydrocortisone, possess strong anti-inflammatory properties, thereby preventing the accumulation of fluid at the site of the surgical area [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

The Prevention of Seroma Formation Following Modified Radical Mastectomy by Intravenous Hydrocortisone Injection

Fatima,

Shafique,

Shabana

et al. 2024

Cureus

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Introduction Seroma formation is the most common complication after modified radical mastectomy (MRM). It leads to increased pain and discomfort, potentially prolonging morbidity and treatment. Various treatment modalities are being used to decrease the incidence of seroma formation. The objective of this study was to compare intravenous hydrocortisone injection versus placebo in patients undergoing MRM in terms of frequency of post-operative seroma formation. Methods This randomized, double-blinded, placebo-controlled study was conducted at Surgical Unit-I, Holy Family Hospital, Rawalpindi, Pakistan from January 2021 to December 2021. A total of 152 female patients were randomly assigned to each of the study and placebo groups. Group I patients received 100 mg of hydrocortisone intravenously while group II patients received one ml of 0.9% normal saline intravenously prior to induction of general anesthesia for MRM. The incidence of seroma formation after 10 days of MRM and total drain volume till their removal was measured in all patients. Results The mean age was 48.42±10.15 in Group I, while it was 47.67±10.75 in Group II. Mean drain output till removal was 99.14±31.01 ml in the hydrocortisone group and 177.57±63.37 ml in the placebo group. Forty-eight patients developed seroma (31.58%), of whom nine received intravenous hydrocortisone and 39 received normal saline (P=0.000). Conclusion Intravenous hydrocortisone is effective in terms of frequency of post-operative seroma formation as compared to placebo in patients undergoing MRM.

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“…Besides, it was also used to treat pancreatic surgical complications, 13 excision of lymphatic malformations, 14 chylothorax, 15 and renal transplantation 16 . It was studied that octreotide could significantly reduce lymph exudation and hospital stay after axillary lymphadenectomy in breast cancer, 4,5 pelvic lymphadenectomy in radical prostatectomy, 6 and kidney transplantation 16 . After neck lymphadenectomy octreotide could not only reduce chyle leakage, but also has high safety and no obvious adverse reactions 17,18 .…”

Section: Discussionmentioning

confidence: 99%

“…At present, there are limited effective methods to prevent lymphorrhea and lymphocele. Octreotide has been reported to be an effective treatment for lymphorrhea after axillary lymphadenectomy 4,5 in breast cancer and pelvic lymphadenectomy in radical prostatectomy. 6 So in this study the efficacy of octreotide to reduce lymphorrhea and prevent lymphocele after pelvic lymphadenectomy in gynecological malignancies was examined.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of octreotide to reduce lymphorrhea and prevent lymphocele after pelvic lymph node excision in gynecological malignancies

Gao

Wang

et al. 2023

J of Obstet and Gynaecol

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Aim To study the efficacy of octreotide to reduce lymphorrhea and prevent lymphocele after pelvic lymph node excision in gynecological malignancies. Methods Patients with more than 200 mL of lymph drained per day until postoperative day 3 after pelvic lymph node excision were enrolled. Of the 75 patients, 36 were managed by conservative methods without the injection of octreotide, and the other 39 patients were treated with the injection of octreotide. The treated group was injected with 0.1 mg octreotide q8h for 5 days, starting on postoperative day 3. The drainage tube was removed when the amount of drained lymph decreased to 100 mL per day. The age, BMI, operation time, removed lymph nodes, amount of lymph, duration of drain placement, proportion of patients with lymphocele and complications between these two group were compared. Results The total and mean daily amount of lymph produced per patient was significantly lower in the octreotide‐treated group than in the untreated group. The duration of drain placement was shorter in the octreotide group than in the untreated group. The proportion of patients with lymphocele in the treatment group was lower than that in the untreated group. Conclusions The injection of octreotide is effective to reduce lymphorrhea and prevent lymphocele after pelvic lymph node excision in gynecological malignancies.

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Effect of Octreotide on Lymphorrhea in Patients After Modified Radical Mastectomy for Carcinoma Breast: A Randomized Controlled Trial

Cited by 6 publications

References 20 publications

The Efficacy and Safety of Somatostatin Analog after Axillary Node Dissection in Breast Cancer: A Systematic Review and Meta-analysis

The Efficacy and Safety of Somatostatin Analog after Axillary Node Dissection in Breast Cancer: A Systematic Review and Meta-analysis

The Prevention of Seroma Formation Following Modified Radical Mastectomy by Intravenous Hydrocortisone Injection

Efficacy of octreotide to reduce lymphorrhea and prevent lymphocele after pelvic lymph node excision in gynecological malignancies

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