Abstract
AimsPostoperative seroma is the most frequent sequelae after mastectomy and axillary surgery with no optimal regimens for seroma resolution recommended in routine clinical. Indwelling cannulas with needle and catheter have been widely used in long-term medication therapies, but evidence of indwelling cannulas in seroma management after mastectomy is lacking. The purpose of this study is to evaluate the feasibility of indwelling cannulas in seroma management after mastectomy.MethodsPatients who underwent modified radical mastectomy (MRM) and developed symptomatic seroma after removal of the drains between August 2017 and December 2018, were randomized into two groups either indwelling cannulas drain of seroma (Group A) or needle aspiration of seroma (Group B). We prospectively compared the number of visits for seroma, the time from removal of the drain to the final seroma resolution and the cost between the methods.ResultsA total of 860 patients underwent MRM between August 2017 and December 2018, among which 86 patients who developed symptomatic seroma after removal of the drains, were randomized into two groups either Group A or Group B. The number of visits for seroma in Group A was 2.35 ± 0.69 times, which was less than those in Group B (4.86 ± 1.06 times). Similarly, the time of drain removal to final seroma resolution in Group A was 4.65 ± 0.78 days, which was shorter than 7.09 ± 1.54 in Group B. In Group A, the total mean cost per patient (25.81 ± 7.71 RMB) was less than the total mean cost per patient (49.30 ± 9.85 RMB) in Group B. Cost savings were noted with using indwelling cannulas in seroma management.ConclusionIt is feasible to drain indwelling cannulas drain for postmastectomy seroma, with less visits for patients, rapid seroma resolution and less cost. Indwelling cannulas can be an efficient, cost effective solution to treat symptomatic seroma after breast surgery.
Highlights
Seroma is the most frequent sequelae occurring after mastectomy with an incidence ranging from 3 to 85% [1,2,3]
The purpose of this study is to evaluate the feasibility of Indwelling cannulas (IC) in seroma management
Patients underwent modified radical mastectomy (MRM) and developed symptomatic seroma after removal of the drains were recruited to participate in this study, which was approved by Institutional Review Board of Fujian Provincial Cancer Hospital
Summary
Seroma is the most frequent sequelae occurring after mastectomy with an incidence ranging from 3 to 85% [1,2,3]. The most frequently used techniques for seroma treatment include drain replacement [6] and multiple needle aspiration depending on seroma size, symptoms, and patient preference. Both methods have well-known limitations and risks. Drain replacement is typically used when the seroma has lasted long after multiple aspiration attempts [7]. It can be uncomfortable for patients and associated with an increased risk of infection.
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