Nikhil Gupta, Dr, Ananya Deori, Dr, Arun K Gupta, Dr, Dipankar Naskar, Dr, C K Durga, Dr. PGIMER Dr RML Hospital, Delhi
Background: The ultrasonic dissector, commonly known as the harmonic scalpel, has been in use for achieving haemostasis in surgery for almost 20 yrs. Its advantages in breast surgery, especially in the dissection of axilla, have been a matter of debate as previous studies have shown inconsistent results. This study compares the outcomes of the ultrasonic dissector in axillary dissection with that of the conventional electrocautery.
Methods: Patients who were undergoing MRM and BCS with axillary dissection from November 2014 till March 2016 were included in the study. Patients were randomized into two groups, group A undergoing axillary dissection with ultrasonic dissector and group B with electrocautery. The operative time, intra-op bleeding, post-op pain, post op drain volume, hospital stay and any other complications were noted in the two groups.
Results: The numbers of patients in both groups were 35 each. Group A had a significantly shorter operative time, both for axillary dissection (30.86 mins vs. 40.63 mins, p<0.001) and the total duration (77.20 vs. 90.20 mins, p=0.001). The blood loss was significantly less in group A, as measured by the mop count. There was significant reduction in the total post-op drainage volume, which resulted in fewer days of drain in-situ and the total number days stayed in the hospital. There was no significant change in the post-op complications such as haematoma, seroma, flap necrosis, oedema, etc.
Conclusion: With the use of ultrasonic dissector, the operative time, blood loss and the axillary drainage was significantly reduced. The axillary drainage in turn, reduced the hospital stay. There was no significant difference in terms of complications like haematoma formation, seroma formation, skin flap necrosis or oedema.
Key words: Breast; axilla; Harmonic; drainage
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84731
Program Number: P078
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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