Surgical resection for persistent seroma, following modified radical mastectomy

Stanczyk, Marek; Grala, Bartłomiej; Zwierowicz, Tomasz; Maruszyński, Marek

doi:10.1186/1477-7819-5-104

Cited by 51 publications

(45 citation statements)

References 14 publications

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“…1 di Iran menunjukkan insidensi sebesar 35%, sedangkan di Polandia berdasarkan laporan Stanczyk dkk. 2 pembentukan seroma terjadi hingga 50% setelah mastektomi. Karakaya dkk.…”

Section: Pendahuluanunclassified

“…Bahkan pernah dilaporkan kasus seroma yang bertahan sampai satu tahun pascaoperasi, sehingga terbentuk seroma fibrous terkapsulasi yang memerlukan suatu tindakan reseksi bedah setelah tindakan konservatif yang dilakukan gagal. 2 Berdasarkan metaanalisis yang dilakukan oleh Kuroi dkk., 6 banyak faktor yang memengaruhi kejadian seroma pascaoperasi kanker payudara. Faktor-faktor yang cukup signifikan yaitu berat badan yang berlebih, mastektomi radikal (bila dibandingkan mastektomi simpel), dan jumlah drainase yang banyak dalam 3 hari pertama.…”

Section: Pendahuluanunclassified

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Efektivitas Pemberian Metilprednisolon terhadap Pembentukan Seroma Pascaoperasi Mastektomi Modifikasi Radikal

Setiawan¹,

Abdurahman²,

Rizki³

2014

mkb

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AbstrakSeroma adalah pengumpulan cairan serous di subkutis dan merupakan komplikasi pascaoperasi kanker payudara yang paling sering dijumpai. Insidensinya mencapai lebih dari 60%. Walaupun tidak mengancam jiwa, namun dapat menimbulkan morbiditas yang serius. Berbagai penelitian dilakukan untuk menentukan faktor risiko untuk mencegah timbulnya seroma. Saat ini, seroma terjadi karena proses inflamasi pascaoperasi. Teori inilah yang mendasari peranan antiinflamasi terhadap pembentukan seroma. Diketahui obat golongan glukokortikoid, memiliki peranan menghambat respons inflamasi. Tujuan penelitian ini untuk menilai efek profilaksis pemberian metilprednisolon perioperatif mastektomi terhadap pembentukan seroma. Penelitian ini merupakan uji klinis secara acak tersamar ganda terhadap 2 kelompok, yaitu antara kelompok karsinoma payudara stadium lokal lanjut yang diberikan metilprednisolon perioperatif mastektomi sebagai kelompok perlakuan dan kontrol. Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung, periode April-Juli 2013. Subjek penelitian meliputi 30 wanita yang memenuhi kriteria inklusi dan dibagi menjadi dua kelompok, 15 pasien diberikan metilprednisolon dan 15 pasien sebagai kontrol. Penelitian ini menggunakan uji-t tidak berpasangan dan Mann Whitney. Didapatkan perbedaan rata-rata volume drainase hari ke-1, pada kelompok metilprednisolon sebanyak 104,7 mL dan pada kontrol sebanyak 158 mL, namun secara statistik tidak bermakna (p=0,053). Demikian pula dengan hari-hari selanjutnya dan total seroma, tidak didapatkan perbedaan yang bermakna. Simpulan, pemberian metilprednisolon tidak efektif menurunkan volume drainase seroma pascaoperasi mastektomi. [MKB. 2014;46(2) Effectiveness of Methylprednisolone on Post-Operative Seroma Formation Following Radical Modified Mastectomy AbstractSeroma is a collection of serous fluid in the subcutaneous and is the most common complication of breast cancer surgery. The incidence is more than 60%. Although it is not life-threatening but it can cause serious morbidity. Various studies were conducted to determine the risk factors to prevent seroma formation. Currently, seroma occurrs due to postoperative inflammatory processes. This theory underlies the antiinflammatory role for seroma formation. Glucocorticoid drugs is known as playing a role in inhibiting the inflammatory response. The purpose of this study was to assess the prophylactic effect of perioperative administration of methylprednisolone on seroma formation. This study was a double-blind randomized control trial of 2 groups, i.e. a group of locally advanced breast carcinoma which were given methylprednisolone perioperatively as a treatment group and a control group. The research was conducted in Dr. Hasan Sadikin General Hospital Bandung from April to July 2013. Thirty women who met the inclusion criteria were included as subjects who were then divided into two groups: 15 women received methylprednisolone and 15 women serve as controls. This study used independent t and Mann-Whitney tests. There was a diff...

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“…1 di Iran menunjukkan insidensi sebesar 35%, sedangkan di Polandia berdasarkan laporan Stanczyk dkk. 2 pembentukan seroma terjadi hingga 50% setelah mastektomi. Karakaya dkk.…”

Section: Pendahuluanunclassified

Efektivitas Pemberian Metilprednisolon terhadap Pembentukan Seroma Pascaoperasi Mastektomi Modifikasi Radikal

Setiawan¹,

Abdurahman²,

Rizki³

2014

mkb

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“…In such patients, the formation of thick fibrous capsules around the seroma was considered as a breach of wound healing recommended for complete surgical removal. 14,15 However, the fragile blood supply of local tissue following radical mastectomy, which was usually deteriorated by subsequent radiotherapy, 16,17 might greatly risk the outcome of extensive debridement.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided scraping of fibrous capsule plus bilayered negative pressure wound therapy for treatment of refractory postmastectomy seroma

Fang

Jiang

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…[2] A reoperation may be necessary for cases of longstanding persistent seroma. [3] This review updates the various factors thought to contribute to seroma formation and the probable interventions that may be of help to reduce incidence.…”

Section: Introductionmentioning

confidence: 99%

Seroma Formation in Cancer Breast Surgery

Sitaram¹,

Hemanthi²

2015

jemds

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Post-operative breast surgery for malignancy has a common side effect of seromas, whose formation and drainage requires a special attention to prevent as much as possible and as early as possible to avoid morbidity. How best we can prevent the dead space is the problem. In this study a review of various methods adopted all over the world is reviewed including early discharge of the patient with drain. It is always preferable to remove the drain when the collection of serum is less than 25ml in 24 hours the chance of re accumulation of fluid is less likely. INTRODUCTION: Carcinoma breast has remained the second leading cause of cancer death among women worldwide over the past three decades [1] and contributes significantly to cancer surgical load. Surgical treatment for breast cancer includes breast conservation therapy and mastectomy with or without axillary dissection depending on disease stage. Seroma formation is the most frequent postoperative Side effect seen after mastectomy and axillary surgery with an incidence of 3% to 85%. OBSERVATIONS: TYPE OF SURGERY: Surgical treatment for breast cancer has undergone a paradigm shift from Halstead's radical mastectomy to breast conservation. It has been demonstrated that radical mastectomy increases seroma formation compared with that of simple mastectomy, but the association is inconclusive when radical mastectomy is compared with modified radical mastectomy (MRM). SURGICAL DEVICES: Various electro-mechanical devices are used during surgery to reduce blood loss and operating time. These include electrocautery, laser scalpel, argon diathermy, ultrasonic scalpel, ultrasonic scissors, and vessel sealing systems. All of these devices have been investigated in an effort to reduce seroma formation. Randomized trials have shown that the use of electrocautery for dissecting flaps is significantly associated with increased seroma formation when compared to that of scalpel dissection. However, no individual study has shown a significant effect on seroma formation with or without the use of a laser scalpel, argon diathermy, or an ultrasonic scalpel. Ultrasonic scissors resulted in reduced seroma formation in a randomized controlled trial comparing level I and II axillary dissection using either ultrasound scissors or surgical scissors with ligation. MANAGEMENT OF DEAD SPACE: MECHANICAL DEVICES: Different techniques have been employed to obliterate the dead space (under flaps and the axilla) to reduce seroma formation. CHEMICAL: Fibrin glue.light activated fibrin sealant, and transdermal photo-polymerized adhesive reduce seroma formation after mastectomy in animal models. Use of a fibrinolysis inhibitor was based on the hypothesis that fibrinolytic activity in serum and lymph might contribute to fluid accumulation. SHOULDER MOVEMENT: Shoulder dysfunction is a common complication of mastectomy,and it is necessary to mobilize the shoulder early to prevent this complication. It was thought that early shoulder mobilization led to increased seroma formation and this hypot...

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Surgical resection for persistent seroma, following modified radical mastectomy

Abstract: We stand in opinion that in some cases of prolonged seromatous effusion with confirmed formation of thick walled reservoir the operation with resection and closure of supplying regional lymph vessels may be the best treatment, if possible preceded by arm lymphoscyntygraphy.

Cited by 51 publications

References 14 publications

Efektivitas Pemberian Metilprednisolon terhadap Pembentukan Seroma Pascaoperasi Mastektomi Modifikasi Radikal

Efektivitas Pemberian Metilprednisolon terhadap Pembentukan Seroma Pascaoperasi Mastektomi Modifikasi Radikal

Ultrasound-guided scraping of fibrous capsule plus bilayered negative pressure wound therapy for treatment of refractory postmastectomy seroma

Seroma Formation in Cancer Breast Surgery

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