FREQUENCY OF SEROMA FORMATION AFTER MODIFIED RADICAL MASTECTOMY. A COMPARISON BETWEEN ELECTROCAUTERY AND SCALPEL DISSECTION TECHNIQUES.
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Keywords
Breast Cancer Surgery, Electrocautery, Modified Radical Mastectomy, Postoperative Complications, Scalpel Dissection, Seroma Formation
Abstract
Background: Modified radical mastectomy remains a standard surgical procedure for breast cancer treatment. However, the choice of dissection technique, either electrocautery or traditional scalpel, can significantly impact postoperative outcomes, particularly seroma formation, which is a common complication following this surgery. Understanding the differences in outcomes between these two techniques is crucial for optimizing patient care.
Objective: This study aims to compare the frequency of seroma formation and other postoperative complications between electrocautery and scalpel dissection techniques in patients undergoing modified radical mastectomy.
Methods: A prospective cohort study was conducted at at multiple centers including Department of General Surgery, MRHSM Hospital Pabbi Nowshera, Jinnah Teaching Hospital Peshawar, Cat C Hospital Tangi Charsadda and DHQ Hospital Daggar Buner in the duration from June, 2023 to November, 2023. Total 240 female patients undergoing modified radical mastectomy. Patients were randomly assigned into two groups: electrocautery (120 patients) and scalpel dissection (120 patients). Demographics measured included age, BMI, smoking status, diabetes, hypertension, previous breast surgeries, and family history of breast cancer. Primary outcome was the incidence of seroma formation, with secondary outcomes including volume of seroma, pain score, wound healing time, infection rates, and length of hospital stay. Statistical analysis involved Chi-square tests, independent samples t-tests, and Repeated measures ANOVA where appropriate.
Results: In a study of 240 patients undergoing modified radical mastectomy, divided between electrocautery (Group 1) and scalpel dissection (Group 2), key differences were noted in postoperative outcomes. Group 1 showed a higher seroma formation rate (31.7% vs. 18.3%, p=0.0253) and longer hospital stays (6.3 vs. 5.7 days, p=0.024). Wound healing was slower (21.4 vs. 19.6 days, p=0.016), and pain scores were consistently higher in Group 1 at all postoperative intervals. However, the increase in infection rates in Group 1 was not statistically significant (p=0.079). Demographic factors, including age, BMI, smoking status, diabetes, hypertension, previous surgeries, and family history, were comparable between groups.
Conclusion: The study concludes that while electrocautery in modified radical mastectomy offers operational efficiency, it is associated with higher rates of seroma formation, prolonged wound healing, increased postoperative pain, and marginally longer hospital stays compared to scalpel dissection. These findings emphasize the need to balance surgical efficiency with potential complications and highlight the importance of effective postoperative care. The study advocates prioritizing patient comfort and recovery in surgical decision-making.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Yaseen Babar
Consultant General Surgeon, Department of General Surgery, MRHSM Hospital Pabbi Nowshera, Khyber Pakhtunkhwa - Pakistan
Raza Ullah
Consultant Surgeon, Department of General Surgery, Cat C Hospital Tangi Charsadda, Khyber Pakhtunkhwa - Pakistan
Monawar Shah
Consultant General Surgeon Jinnah Teaching Hospital Peshawar, Khyber Pakhtunkhwa - Pakistan
Ajab Khan
Consultant General Surgeon, DHQ Hospital Daggar Buner, Khyber Pakhtunkhwa - Pakistan