Usefulness of ultrasound scissors in reducing serous drainage after axillary dissection for breast cancer: a prospective randomized clinical study

Axillary dissection is usually associated with prolonged serous drainage that may result in several complications. We analyzed whether the use of ultrasound scissors may decrease the total amount of drainage from the axilla (AD) in patients requiring curative surgery for breast cancer. Seventy-six women (median age, 56 years; range, 32-73 years) with confirmed pT1-3, N0-1 breast cancer were prospectively randomly assigned to undergo mastectomy or breast-conserving surgery with axillary dissection by either using (group A) or not using (group B) ultrasound scissors. Overall, there was a linear relationship (P < 0.05) between AD and both total number of the removed nodes and body mass index, whereas no correlation (P = NS) was found with age and size of the tumor. Total AD was higher (492 +/- 153 vs. 408 +/- 136 mL, P = 0.013) in group B, whereas the postoperative hospital stay was shorter (2.4 +/- 0.6 vs. 2.7 +/- 0.7 days, P = NS) in group A. The three-way analysis of covariance using the number of total removed nodes as covariate showed that lymph node status, type of operation, and technique for axillary dissection significantly (P < 0.05) correlated with AD. In conclusion, our initial study shows that the use of ultrasound scissors significantly reduced total AD in patients requiring axillary dissection and may shorten hospital stay.