Seroma Formation After Mastectomy and Axillary Dissection; A Comparison Among Blunt Dissection With Hemostat, Sharp Dissection With Metzenbaum Scissors, and Dissection With Harmonic Scissors

Background: Seroma formation is a common complication after surgery forbreast cancer. It may originate from dissected lymphatic ducts in axillary area. Twoimportant predictive factors are the surgical technique, and instruments used duringsurgery. This study was conducted to determine the impact of three axillarydissection techniques, namely, blunt dissection with hemostat, sharp dissection withMetzenbaum scissors, and dissection with harmonic scissors, on seroma formation. Methods: Patients with a tissue diagnosis of breast cancer who did not havemetastasis, and were candidates for either breast conservation surgery (BCS) andsentinel lymph node biopsy (SLNB) with or without axillary lymph nodedissection (ALND), or modified radical mastectomy (MRM) were included in aprospective study. Patients were randomly allocated to one of the above mentionedthree groups. The incidence of seroma formation was compared among the groups. Results: Sixty patients (age: ۵۰.۲۵ ± ۱۰.۳۳ years) were enrolled for the study.At the end of the study, after four weeks of postoperative follow up, ۱۹ patientsdeveloped seroma (۳۱.۶%), of whom ۵ (۲۶.۳%) had dissection with harmonicscissors, ۶ (۳۱.۵%) with Metzenbaum scissors, and ۸ (۴۲.۱%) were dissectedbluntly. There was no significant difference among groups regarding seromaformation (P = ۰.۵۸۳). Conclusion: Application of harmonic scissors for axillary dissection has nosignificant impact on seroma formation. However, MRM leads to significantlymore seroma formation compared with BCS.

Keywords:

Harmonic scissors , seroma , breast cancer , axillary lymph node , dissection , sentinel lymph node , biopsy , modified radical mastectomy , breast conservation surgery