Patients with breast cancer (BC) and positive sentinel node biopsy usually require axillary dissection, that may still result in prolonged serous drainage and seroma formation. The aim of this study was to evaluate the efficacy of ultrasonic shear (Harmonic scalpel) axillary dissection compared with conventional dissection.Materials and methods: Ninety-four consecutive women (median age 52 years, range 30-75 years) with confirmed pT1-2 primary BC undergoing curative surgery were recruited over a twelve-month period. Patients were randomly divided into two age-matched groups: Group A, 46 patients, ultrasonic shear technique vs. Group B, 48 patients, conventional technique. Body mass index (BMI), surgical time, number of both total and positive removed nodes, total amount of drainage (AD) from the axilla were recorded by the nursing and medical staff. The unpaired Student’s t-test and the Pearson’s coefficient (R) calculation were used for statistical analysis. Results: Overall, 28 (29.8%) patients underwent modified radical mastectomy (Group A¼12, Group B¼16), and 66 (70.2%) patients underwent breast-conserving surgery Group A¼32, Group B¼34). In each Groups, there was a linear relationship (p<0.05) between AD and both BMI and total number of the removed nodes, but no correlations were found (p¼NS) with age of the patients, type of breast surgery (mastectomy vs. breast conserving), and greatest diameter of the tumour (pT). The mean surgical time for Group A patients was shorter, but not significantly (p¼NS), while total AD was higher (45686 vs. 40278 mL; p¼0.02) for Group B patients. Conclusions: Our study suggests that in patients with BC requiring axillary dissection the use of ultrasonic shears is more time-efficient than conventional surgery, significantly reducing the amount of serous drainage, especially in patients with low BMI.

Usefulness of harmonic scalpel in patients with breast cancer undergoing axillary dissection - a prospective case-control study.

LUMACHI, FRANCO;ERMANI, MARIO;
2008

Abstract

Patients with breast cancer (BC) and positive sentinel node biopsy usually require axillary dissection, that may still result in prolonged serous drainage and seroma formation. The aim of this study was to evaluate the efficacy of ultrasonic shear (Harmonic scalpel) axillary dissection compared with conventional dissection.Materials and methods: Ninety-four consecutive women (median age 52 years, range 30-75 years) with confirmed pT1-2 primary BC undergoing curative surgery were recruited over a twelve-month period. Patients were randomly divided into two age-matched groups: Group A, 46 patients, ultrasonic shear technique vs. Group B, 48 patients, conventional technique. Body mass index (BMI), surgical time, number of both total and positive removed nodes, total amount of drainage (AD) from the axilla were recorded by the nursing and medical staff. The unpaired Student’s t-test and the Pearson’s coefficient (R) calculation were used for statistical analysis. Results: Overall, 28 (29.8%) patients underwent modified radical mastectomy (Group A¼12, Group B¼16), and 66 (70.2%) patients underwent breast-conserving surgery Group A¼32, Group B¼34). In each Groups, there was a linear relationship (p<0.05) between AD and both BMI and total number of the removed nodes, but no correlations were found (p¼NS) with age of the patients, type of breast surgery (mastectomy vs. breast conserving), and greatest diameter of the tumour (pT). The mean surgical time for Group A patients was shorter, but not significantly (p¼NS), while total AD was higher (45686 vs. 40278 mL; p¼0.02) for Group B patients. Conclusions: Our study suggests that in patients with BC requiring axillary dissection the use of ultrasonic shears is more time-efficient than conventional surgery, significantly reducing the amount of serous drainage, especially in patients with low BMI.
2008
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2273039
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