A modified technique for a common problem after major duct excision

Abstract

Objective The present study aims to describe and evaluate a modified major duct excision (MDE) technique as regards its role in minimizing postoperative complications. Patients and methods We included female patients who underwent total duct excision due to the following indications: suspicious nipple discharge, periductal mastitis, and nipple retraction with a history of periductal mastitis. The modified MDE was performed under general anesthesia. All the patients were discharged home on the same day of the procedure and they were followed up for 6 months. In the follow-up, the patients were assessed for any complications to the wound, any retraction or necrosis to the nipple, the nipple sensation compared with the other one, or the nearby skin in bilateral cases. Results In this study, a total of 29 operations were performed on the 25 patients. No seroma or hematomas were observed. On follow-up of the patients, two patients suffered from infection of the wound, three cases developed breakdown that healed by daily dressing, one case presented with nipple necrosis most probably occurred as a result of excessive dissection with diathermy, while the remaining 31 patients recovered by primary intention with no recurrent discharge. Loss of nipple sensation occurred in four patients, impaired sensation occurred in six patients, and normal sensation in the rest of the patients was observed at 6 months of follow-up. Conclusion The modified MDE technique is a safe alternative to the classic technique with low rate of postoperative complications.