The utility of pectoral drain in patients undergoing modified radical mastectomy-an observational study

Abstract

Background: Breast cancer is one of the most common malignancies in female and in developing countries majority of them present in locally advanced stages. Modified radical mastectomy (MRM) is the main surgical management & axillary drain is deployed to tackle the leaking axillary lymphatics. However, if at all the pectoral area between the skin flaps and pectoral muscles requires drainage can be contested since the skin flaps are snugly approximated to the chest wall obliterating any potential space. The study is conducted to evaluate the output of pectoral drain & axillary drain in patients of MRM.Methods: This is a prospective study of 120 consecutive patients over a 2-years period who presented with breast cancer and undergone MRM in a teaching hospital. Two separate drains equal in all parameters were inserted in axilla and pectoral area and the collection in these drains studied post operatively.Results: The contribution of pectoral drain to total drain output was only 7.97%, while the axillary drain contribution was 92.03% in total drain output. So, the contribution from the pectoral drain was statistically insignificant (p=<0.001).Conclusions: MRM can be performed without drainage at the pectoral area.

Perbandingan Pemakaian Satu Drain dengan Dua Drain Aktif Terhadap Volume Seroma dan Lama Pemakaian Drain Paska Modified Radical Mastectomy di RSUP Sanglah Denpasar

“…Komponen yang ada pada hari pertama post operatif didapatkan mengandung darah. Pada hari berikutnya, komponen cairan tersebut berubah menjadi cairan yang menyerupai cairan limfe dengan kandungan protein yang lebih banyak dan tanpa fibrinogen, sehingga koagulasi tidak terjadi 11 .…”

“…4 Berdasarkan penelitian ini juga didapatkan bahwa pada hari ke-3 ketika drain pada tumor bed dilepas, rerata volume seroma yang di hasilkan adalah 25,32 cc sedangkan pada aksila rerata volume yang di hasilkan secara keseluruhan adalah 192,75 cc. Hasil ini sesuai dengan penelitian yang dilakukan oleh Kumar, dkk yang membandingkan efektivitas penempatan drain pada aksila dan pektoral/ dinding dada didapatkan hasil total volume cairan drain pada drain aksila rata-rata sebanyak 337 cc sedangkan pada drain pektoral sebanyak 29 cc 11 . Kontribusi drain aksila pada total volume cairan drain (aksila dan pektoralis) sebesar 92,03% sedangkan drain pektoral sebesar 7,97%.…”