Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy
Identifieur interne : 000491 ( Main/Exploration ); précédent : 000490; suivant : 000492Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy
Auteurs : Olivier Gié ; Marie-Laure Matthey-Gié ; Pedro-Manuel Marques-Vidal ; Nicolas Demartines ; Maurice MatterSource :
- BMC Surgery [ 1471-2482 ] ; 2017.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Lymphadénectomie.
- étiologie : Lymphadénectomie, Procédures de chirurgie par ultrasons, Sérome.
- Adulte, Adulte d'âge moyen, Aine, Aisselle, Drainage, Femelle, Humains, Lymphe, Mâle, Sujet âgé, Sérome, Études prospectives.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Lymph Node Excision.
- etiology : Seroma.
- instrumentation : Lymph Node Excision, Ultrasonic Surgical Procedures.
- therapy : Seroma.
- Adult, Aged, Axilla, Drainage, Female, Groin, Humans, Lymph, Male, Middle Aged, Prospective Studies.
Abstract
Seroma formation and lymphoedema are frequently encountered complications after radical lymph node dissection (RLND). Attempts to reduce the lymphatic morbidity include the use of Ultrasonic Scalpel. The aim of the present analysis was to assess the impact of the ultrasonic scalpel on the amount of drained lymph after lymph node dissection.
Patients listed for a RLND or completion lymph node dissection (CLND) were enrolled in a prospective randomized trial to compare the impact of two surgical dissection techniques (USS versus control) on the amount of drained lymph. The lymph drained in 24 h was collected. Our primary endpoint was to compare the daily amount of drained lymph between the two groups. Secondary endpoints were the comparison of drained lymph with the BMI of the patients, the gender and the surgical site (axilla, groin).
Eighty patients were randomly assigned to the USS group or the Control (C) group. No difference was measured in the total amount of lymph drained (USS: 2908 ± 2453 ml vs. C: 3898 ± 5791 ml;
The study suggests that the use of Harmonic scalpel did not influence the amount of lymph drained after RLND and not support the theory that USS induces oversealing of lymphatics.
Clinical Trial
Url:
DOI: 10.1186/s12893-017-0222-1
PubMed: 28327108
PubMed Central: 5360050
Affiliations:
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Demartines</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28327108</idno><idno type="pmc">5360050</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360050</idno><idno type="RBID">PMC:5360050</idno><idno type="doi">10.1186/s12893-017-0222-1</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000C89</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C89</idno><idno type="wicri:Area/Pmc/Curation">000C88</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C88</idno><idno type="wicri:Area/Pmc/Checkpoint">000242</idno><idno type="wicri:explorRef" wicri:stream="Pmc" 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inguinal lymphadenectomy</title><author><name sortKey="Gie, Olivier" sort="Gie, Olivier" uniqKey="Gie O" first="Olivier" last="Gié">Olivier Gié</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matthey Gie, Marie Laure" sort="Matthey Gie, Marie Laure" uniqKey="Matthey Gie M" first="Marie-Laure" last="Matthey-Gié">Marie-Laure Matthey-Gié</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Marques Vidal, Pedro Manuel" sort="Marques Vidal, Pedro Manuel" uniqKey="Marques Vidal P" first="Pedro-Manuel" last="Marques-Vidal">Pedro-Manuel Marques-Vidal</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">BMC Surgery</title><idno type="eISSN">1471-2482</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Axilla</term><term>Drainage</term><term>Female</term><term>Groin</term><term>Humans</term><term>Lymph</term><term>Lymph Node Excision (adverse effects)</term><term>Lymph Node Excision (instrumentation)</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Seroma (etiology)</term><term>Seroma (therapy)</term><term>Ultrasonic Surgical Procedures (instrumentation)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aine</term><term>Aisselle</term><term>Drainage</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphadénectomie (instrumentation)</term><term>Lymphe</term><term>Mâle</term><term>Procédures de chirurgie par ultrasons (instrumentation)</term><term>Sujet âgé</term><term>Sérome ()</term><term>Sérome (étiologie)</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Seroma</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Lymph Node Excision</term><term>Ultrasonic Surgical Procedures</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Seroma</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphadénectomie</term><term>Procédures de chirurgie par ultrasons</term><term>Sérome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Axilla</term><term>Drainage</term><term>Female</term><term>Groin</term><term>Humans</term><term>Lymph</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aine</term><term>Aisselle</term><term>Drainage</term><term>Femelle</term><term>Humains</term><term>Lymphe</term><term>Mâle</term><term>Sujet âgé</term><term>Sérome</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Seroma formation and lymphoedema are frequently encountered complications after radical lymph node dissection (RLND). Attempts to reduce the lymphatic morbidity include the use of Ultrasonic Scalpel. The aim of the present analysis was to assess the impact of the ultrasonic scalpel on the amount of drained lymph after lymph node dissection.</p></sec><sec><title>Methods</title><p>Patients listed for a RLND or completion lymph node dissection (CLND) were enrolled in a prospective randomized trial to compare the impact of two surgical dissection techniques (USS versus control) on the amount of drained lymph. The lymph drained in 24 h was collected. Our primary endpoint was to compare the daily amount of drained lymph between the two groups. Secondary endpoints were the comparison of drained lymph with the BMI of the patients, the gender and the surgical site (axilla, groin).</p></sec><sec><title>Results</title><p>Eighty patients were randomly assigned to the USS group or the Control (C) group. No difference was measured in the total amount of lymph drained (USS: 2908 ± 2453 ml vs. C: 3898 ± 5791 ml; <italic>p</italic>-value = 0.382). The result was also similar after adjusting for gender, age, and BMI. A significant higher amount of lymph was measured after inguinal dissection with USS compared to axillary (<italic>p</italic> < 0.001).</p></sec><sec><title>Conclusion</title><p>The study suggests that the use of Harmonic scalpel did not influence the amount of lymph drained after RLND and not support the theory that USS induces oversealing of lymphatics.</p></sec><sec><title>Trial registration</title><p>Clinical Trial <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/results?term=02476357&pg=1">NCT02476357</ext-link>. 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Dogan</name></author><author><name sortKey="Nalbant, H" uniqKey="Nalbant H">H Nalbant</name></author><author><name sortKey="Akinci, M" uniqKey="Akinci M">M Akinci</name></author><author><name sortKey="Karaman, N" uniqKey="Karaman N">N Karaman</name></author><author><name sortKey="Ozaslan, C" uniqKey="Ozaslan C">C Ozaslan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kozomara, D" uniqKey="Kozomara D">D Kozomara</name></author><author><name sortKey="Galic, G" uniqKey="Galic G">G Galic</name></author><author><name sortKey="Brekalo, Z" uniqKey="Brekalo Z">Z Brekalo</name></author><author><name sortKey="Sutalo, N" uniqKey="Sutalo N">N Sutalo</name></author><author><name sortKey="Kvesic, A" uniqKey="Kvesic A">A Kvesic</name></author><author><name sortKey="Soljic, M" uniqKey="Soljic M">M Soljic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Deo, Sv" uniqKey="Deo S">SV Deo</name></author><author><name sortKey="Shukla, Nk" uniqKey="Shukla N">NK Shukla</name></author><author><name sortKey="Asthana, S" uniqKey="Asthana S">S Asthana</name></author><author><name sortKey="Niranjan, B" uniqKey="Niranjan B">B Niranjan</name></author><author><name sortKey="Srinivas, G" uniqKey="Srinivas G">G Srinivas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kontos, M" uniqKey="Kontos M">M Kontos</name></author><author><name sortKey="Kothari, A" uniqKey="Kothari A">A Kothari</name></author><author><name sortKey="Hamed, H" uniqKey="Hamed H">H Hamed</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Galatius, H" uniqKey="Galatius H">H Galatius</name></author><author><name sortKey="Okholm, M" uniqKey="Okholm M">M Okholm</name></author><author><name sortKey="Hoffmann, J" uniqKey="Hoffmann J">J Hoffmann</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><name sortKey="Gie, Olivier" sort="Gie, Olivier" uniqKey="Gie O" first="Olivier" last="Gié">Olivier Gié</name><name sortKey="Marques Vidal, Pedro Manuel" sort="Marques Vidal, Pedro Manuel" uniqKey="Marques Vidal P" first="Pedro-Manuel" last="Marques-Vidal">Pedro-Manuel Marques-Vidal</name><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><name sortKey="Matthey Gie, Marie Laure" sort="Matthey Gie, Marie Laure" uniqKey="Matthey Gie M" first="Marie-Laure" last="Matthey-Gié">Marie-Laure Matthey-Gié</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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