PDF(Pubmed)
Abstract：
UNASSIGNED: The purpose of this study is to evaluate the potential of a novel surgical procedure, the Total Sealing Technique (TST), using the latest bipolar vessel sealing system (BVSS; LigaSure™ Exact Dissector) to reduce lymphatic leakage and seroma formation after electrocautery axillary lymph node dissection (ALND) in breast cancer surgery. Prolonged drainage is a common occurrence after ALND, primarily due to lymphatic leakage. In addition, the presence of seroma often leads to delays in the administration of postoperative adjuvant chemotherapy even after drain removal.
UNASSIGNED: We conducted a comparative analysis of 36 patients who underwent total mastectomy with ALND using conventional electrocautery technique (CONV) during the first 3 years, and 35 patients who underwent the same procedure using TST during the subsequent 3 years. The following factors were compared to assess the impact of TST: operation time, blood loss, total drainage volume, mean time to drain removal, postoperative hospital stay, mean time to initiation of postoperative chemotherapy, and postoperative complications in each group.
UNASSIGNED: TST significantly reduced drainage volume (360.5 vs. 820.6 mL, p < 0.001), days to drain removal (4.8 vs. 6.8 days, p < 0.001), postoperative hospital stay (5.9 vs. 9.6 days, p < 0.001), the incidence of seroma (28.6 % vs. 65.9 %, p = 0.001), and time to chemotherapy initiation (33.1 vs. 61.4 days, p < 0.001) compared to CONV.
UNASSIGNED: TST in total mastectomy with ALND effectively decreases the incidence of lymphorrhea and seroma formation; thus, it can be recommended for total mastectomy with ALND.
UNASSIGNED: We conducted a comparative analysis of 36 patients who underwent total mastectomy with ALND using conventional electrocautery technique (CONV) during the first 3 years, and 35 patients who underwent the same procedure using TST during the subsequent 3 years. The following factors were compared to assess the impact of TST: operation time, blood loss, total drainage volume, mean time to drain removal, postoperative hospital stay, mean time to initiation of postoperative chemotherapy, and postoperative complications in each group.
UNASSIGNED: TST significantly reduced drainage volume (360.5 vs. 820.6 mL, p < 0.001), days to drain removal (4.8 vs. 6.8 days, p < 0.001), postoperative hospital stay (5.9 vs. 9.6 days, p < 0.001), the incidence of seroma (28.6 % vs. 65.9 %, p = 0.001), and time to chemotherapy initiation (33.1 vs. 61.4 days, p < 0.001) compared to CONV.
UNASSIGNED: TST in total mastectomy with ALND effectively decreases the incidence of lymphorrhea and seroma formation; thus, it can be recommended for total mastectomy with ALND.
摘要：
■这项研究的目的是评估一种新型外科手术的潜力，全密封技术(TST),使用最新的双极血管密封系统（BVSS;LigaSure™精确解剖器）减少乳腺癌手术中电切腋窝淋巴结清扫术（ALND）后的淋巴渗漏和血清肿形成。延长排水是ALND后常见的情况，主要是由于淋巴渗漏。此外,血清肿的存在通常会导致术后辅助化疗的延迟，即使在引流后也是如此。
■我们对36例患者进行了比较分析，这些患者在头3年中使用常规电灼技术（CONV）进行了ALND全乳房切除术，和35名患者在随后的3年中使用TST进行了相同的手术。比较以下因素以评估TST的影响：手术时间，失血,总排水量,排水去除的平均时间，术后住院时间,开始术后化疗的平均时间，各组术后并发症。
■TST显着减少了排水量（360.5vs.820.6mL,p<0.001)，排水去除天数(4.8vs.6.8天,p<0.001)，术后住院时间（5.9vs.9.6天,p<0.001)，血清肿的发生率(28.6%vs.65.9%,p=0.001),和化疗开始时间（33.1vs.61.4天，p<0.001)与CONV相比。
■在ALND全乳房切除术中使用TST可有效降低淋巴漏和血清肿形成的发生率；因此，它可以推荐用于ALND全乳房切除术。
■我们对36例患者进行了比较分析，这些患者在头3年中使用常规电灼技术（CONV）进行了ALND全乳房切除术，和35名患者在随后的3年中使用TST进行了相同的手术。比较以下因素以评估TST的影响：手术时间，失血,总排水量,排水去除的平均时间，术后住院时间,开始术后化疗的平均时间，各组术后并发症。
■TST显着减少了排水量（360.5vs.820.6mL,p<0.001)，排水去除天数(4.8vs.6.8天,p<0.001)，术后住院时间（5.9vs.9.6天,p<0.001)，血清肿的发生率(28.6%vs.65.9%,p=0.001),和化疗开始时间（33.1vs.61.4天，p<0.001)与CONV相比。
■在ALND全乳房切除术中使用TST可有效降低淋巴漏和血清肿形成的发生率；因此，它可以推荐用于ALND全乳房切除术。
