Randomized Clinical Trial Comparing Two Mastectomy Techniques

Rodd, C.D.; Velchuru, Vamsi; Holly-Archer, F.; Clark, Allan; Pereira, Jerome

doi:10.1007/s00268-007-9000-z

Cited by 9 publications

(3 citation statements)

References 16 publications

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“…The reason for the decreased incidence of seroma in both groups might be the adherence of the flap to the skin and the sealing of lymphatic vessels. Rodd CD et al and Rebeiro GH et al in their studies demonstrated no significant difference in seroma formation between the two groups [ 13 , 15 ]. The current study also had similar results.…”

Section: Discussionmentioning

confidence: 98%

“…The studies by Parveen S et al and Galatius H et al reported a significant decrease in intraoperative time with the harmonic scalpel when compared to electrocautery [ 10 , 12 ]. However, a few studies have shown no significant difference in operating time [ 12 - 13 ]. The present study has also demonstrated that there is a significant difference in the duration of surgery when the harmonic scalpel is used, versus electrocautery.…”

Section: Discussionmentioning

confidence: 99%

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Comparing the Harmonic Scalpel with Electrocautery in Reducing Postoperative Flap Necrosis and Seroma Formation after Modified Radical Mastectomy in Carcinoma Breast Patients: A Double-Blind Prospective Randomized Control Trail

Archana

Sureshkumar

Vijayakumar

et al. 2018

Cureus

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IntroductionOnly a few studies compare the efficacy of the harmonic scalpel and electrocautery in performing mastectomies, and these have mainly compared their intraoperative parameters. But the main concern with electrocautery is the incidence of flap necrosis and seroma formation. Therefore, this study was done to determine if the harmonic scalpel has any advantages over electrocautery in reducing postoperative flap necrosis and seroma formation in patients undergoing a modified radical mastectomy (MRM).MethodologyThis randomized control trial was carried out over a one-year period in a tertiary care centre in South India. The study patients were randomized into an electrocautery group and a harmonic scalpel group. In the first group, mastectomy including flap and axillary dissection was done using electrocautery. In the second group, a harmonic scalpel was used for dissection. This study compared the efficacy of the harmonic scalpel with electrocautery in terms of postoperative seroma formation and flap necrosis. Various other perioperative parameters like the number of drain days, total drainage volume (in mL), operating time (in minutes), intraoperative blood loss (in mL), and postoperative wound site pain were also studied. During each postoperative visit, the presence of seroma was assessed clinically, and the number of aspirations required for the seroma was also analysed.ResultsA total of 240 patients were randomized into two groups of 120 patients each. Baseline parameters were comparable across both groups. There were significant differences in the duration of surgery [151.38 mins vs. 112.33 mins; p = 0.001] and intraoperative blood loss [276.25 mL vs.200.13 mL; p = 0.001]. On Postoperative Day (POD) 1, the difference in the mean pain scores [6 vs. 4; p = 0.001] was statistically significant. In addition, the differences in the mean total drainage volume [937.5 mL vs. 470 mL; p = 0.002] and the incidence of seroma during the first follow-up [34.2% vs. 21.7 %; p = 0.030] were statistically significant. The difference in the incidence of flap necrosis on POD 4 [7.5% vs. 4.2%; p = 0.2706] was not statistically significant. None of the patients developed flap necrosis after four days.ConclusionThe harmonic scalpel reduces the total drainage volume of seromas, the number of drain days, intraoperative blood loss, duration of surgery, postoperative pain (especially on POD 1 and 5), and incidence of flap necrosis.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Comparing the Harmonic Scalpel with Electrocautery in Reducing Postoperative Flap Necrosis and Seroma Formation after Modified Radical Mastectomy in Carcinoma Breast Patients: A Double-Blind Prospective Randomized Control Trail

Archana

Sureshkumar

Vijayakumar

et al. 2018

Cureus

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“…Electrocautery has been used worldwide for performing MRM. It is associated with less blood loss, rapid operative time, cost-effectiveness with conflicting results about increased seroma formation (1)(2)(3)(4)(5)(6). Classically, the technique is combined with ligation of medial perforators from the intermarry mammary artery as well as tributaries of the axillary vein (7)(8)(9).…”

Section: Introduction Introductionmentioning

confidence: 99%

Sutureless Mastectomy Using Monopolar Electrocautery Only - A Report of 100 Consequent Cases

Hamdy¹

2020

SGO

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Background: Electrocautery has been used worldwide for performing MRM as it is associated with less blood loss, rapid operative time and cost-effectiveness with conflicting results about increased seroma formation. Its use is combined with ligation of the medium sized blood vessels from internal mammary artery and axillary vein. Methods: 100 mastectomies was performed from June 2015 to April 2019 using monopolar electrocautery only for skin flaps elevation, axillary dissection and control of all included blood vessels as well as hemostasis Results: The mean operative time was 45 minutes and the mean discharge date was one day while 83 patients had no complications, 14 patients had minor complications (seroma, slipped drain and wound dehiscence) and three patients had major complications; pulmonary embolism, reactionary bleeding as well as secondary bleeding. Conclusions: Sutureless mastectomy using monopolar electrocautery only is a safe, costeffective and rapid technique which can be adopted for routine used in breast cancer operations.

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Scientific Surgery

2007

British Journal of Surgery

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Randomized Clinical Trial Comparing Two Mastectomy Techniques

Abstract: There is strong evidence that using electric scissors reduces intraoperative blood loss and operating time. There is some evidence that the scissors may provide better surgical completeness of mastectomy.

Cited by 9 publications

References 16 publications

Comparing the Harmonic Scalpel with Electrocautery in Reducing Postoperative Flap Necrosis and Seroma Formation after Modified Radical Mastectomy in Carcinoma Breast Patients: A Double-Blind Prospective Randomized Control Trail

Comparing the Harmonic Scalpel with Electrocautery in Reducing Postoperative Flap Necrosis and Seroma Formation after Modified Radical Mastectomy in Carcinoma Breast Patients: A Double-Blind Prospective Randomized Control Trail

Sutureless Mastectomy Using Monopolar Electrocautery Only - A Report of 100 Consequent Cases

Scientific Surgery

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