Modified radical mastectomy: A pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel

Ribeiro, Gustavo Henrique Fabri Pereira; Kerr, Lígia Maria; Haikel, Raphael Luiz; Peres, Stela Verzinhasse; Matthes, Ângelo Gustavo Zucca; Michelli, Rodrigo Augusto Depieri; Bailão, Ant Ônio; Fregnani, José Humberto Tavares Guerreiro; Vieira, René Aloísio da Costa

doi:10.1016/j.ijsu.2013.03.013

Cited by 23 publications

(25 citation statements)

References 24 publications

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“…Similar results have been shown in studies by Kozomara et al .,[21] Ribeiro et al .,[24] and Rohaizak et al . [17] Infection was more common in patients who developed seroma, hematoma, or flap necrosis.…”

Section: Discussionsupporting

confidence: 92%

A comparative study of the use of harmonic scalpel versus unipolar cautery in modified radical mastectomy

et al. 2017

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Context:Oncosurgery is an emerging branch with the set goals of prolonging the life and ensuring the best possible quality of life to the surviving patient. The use of harmonic scalpel has proved to be beneficial in a variety of surgeries but its role in breast surgery is still controversial.Aims:We conducted this study to compare the intraoperative and postoperative outcomes in modified radical mastectomy using harmonic scalpel versus electrocautery.Subjects and Methods:Fifty female patients with confirmed diagnosis of breast carcinoma and planned for modified radical mastectomy were taken up for surgery. Twenty-five patients were operated using harmonic scalpel (Group A) and another 25 were operated using unipolar cautery (Group B).Results:The mean operative time was significantly longer with harmonic scalpel when compared to that with electrocautery (140.40 ± 29.96 vs. 99.80 ± 24.00 min, P < 0.001). The smaller amount of drainage content (431.60 ± 145.94 vs. 594.20 ± 278.63, P = 0.013) and intraoperative blood loss (426.00 ± 76.54 vs. 502.00 ± 104.56, P = 0.005) in the group operated with the ultrasound harmonic scalpel was statistically significant. There was no significant difference between the groups with regard to drain duration (5.24 ± 0.97, P = 0.127), seroma (12% vs. 16%, P = 0.684), hematoma (4% vs. 4%, P = 1.000), wound infection (24% vs. 32%, P = 0.529), flap necrosis (8% vs. 28%, P = 0.066), pain intensity (measured on visual analog scale) (5.08 ± 1.29 vs. 5.20 ± 1.68, P = 0.778), and lymphedema (4% vs. 8%, P = 0.552). The length of hospital stay could not be compared effectively because all the patients were discharged on the 10th or 11th postoperative day. The cost of the equipment used in the electrocautery group was almost negligible as compared to the harmonic group.Conclusions:The use of harmonic scalpel versus electrocautery is somewhat advantageous but not cost-effective.

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Section: Discussionsupporting

confidence: 92%

A comparative study of the use of harmonic scalpel versus unipolar cautery in modified radical mastectomy

et al. 2017

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“…In our study, mean drain output in electrocautery group was 471.3ml and 387.1ml in ultrasonic shear group. Except for the results reported by Ribeiro GH et al, 3 the mean drain output in our study was lesser than the studies done by Deo S et al, 5 Rohaizak Met al 11 and Mittal et al 6 The mean drain output in our study in the electrocautery patients was higher than the electrocautery group. This is statistically significant (P <0.0001).…”

Section: Discussioncontrasting

confidence: 87%

“…In our study, mean blood loss in electrocautery group was 417.1ml and 370.0ml in ultrasonic shear group. Except for the results reported by Ribeiro GH et al, 3 the mean blood loss in the harmonic group has been indicated to be significantly less as compared to the electrocautery group.…”

Section: Discussionmentioning

confidence: 68%

“…[7][8][9][10] In the present study mean operative time for electrocautery patients was 111.0 min and 126.3 min for ultrasonic shear patients. The studies of Ribeiro GH et al, 3 and DeoS et al 5 showed lesser operative time in both study groups. This according to them is not statistically significant.…”

Section: Discussionmentioning

confidence: 77%

“…This is associated with less lateral thermal spread and better and faster haemostasis. 3 Previous studies using ultrasonic shear in MRM showed lesser intraoperative blood loss and lesser postoperative wound related morbidities. Ultrasonic shear has been previously used in our institute in laparoscopic surgery and open abdominal surgeries.…”

Section: Introductionmentioning

confidence: 95%

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2020

MIJOSUR

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Background: Breast cancer is the most common site-specific cancer in women. During modified radical mastectomy, conventionally, electric scalpel is used for raising skin flaps and achieving haemostasis. In ultrasonic shear, high frequency sound waves are used for cutting and coagulation. Aim: To compare intraoperative outcomes of MRM using electrocautery and ultrasonic shear by comparing intraoperative parameters. Material and Methods: A total of 56 patients were non-randomly allotted to each of the following groups: In Group-A, Electrocautery was used for making flaps and dissection. In Group-B, Ultrasonic shear was used for making flaps and dissection. Total intraoperative blood loss, operative time, drain volume per day was calculated. Results: The mean blood loss in Group-A patients was 417.1±60.4ml.The mean blood loss in Group-B patients was 370.0±50.8ml. There has been a statistically significant decrease in blood loss in Group-B (p<0.05, p=0.0026). Mean operative time in Group-A patients was 111.0±8.4 minutes. Mean operative time in Group-B patients was 126.3±9.9 minutes. There has been a statistically significant increase in the mean operative time in Group-B (p<0.0001). Conclusion: Use of ultrasonic shear in MRM is associated with lesser intraoperative blood loss, lesser total drain output, early removal of drain but it is associated with longer operative time.

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Complications of Breast Surgery and Their Management

Kontos

Markopoulos²

2017

Breast Cancer Management for Surgeons

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Modified radical mastectomy: A pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel

Abstract: HSs do not decrease the seroma rate. However, this method may be useful in skin sparing mastectomy because it decreases skin flap necrosis.

Cited by 23 publications

References 24 publications

A comparative study of the use of harmonic scalpel versus unipolar cautery in modified radical mastectomy

A comparative study of the use of harmonic scalpel versus unipolar cautery in modified radical mastectomy

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Complications of Breast Surgery and Their Management

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