Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial
Identifieur interne : 000686 ( Main/Exploration ); précédent : 000685; suivant : 000687Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial
Auteurs : Ruffo Freitas-Junior ; Luís Fernando Jubé Ribeiro ; Marise Amaral Rebouças Moreira ; Geraldo Silva Queiroz ; Maurício Duarte Esperidião ; Marco Aurélio Costa Silva ; Rubens José Pereira ; Rossana Araújo Catão Zampronha ; Rosemar Macedo Sousa Rahal ; Leonardo Ribeiro Soares ; Danielle Laperche Dos Santos ; Maria Virginia Thomazini ; Cassiana Ferreira Silva De Faria ; Régis Resende PaulinelliSource :
- Clinics [ 1807-5932 ] ; 2017.
Abstract
This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection.
The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552.
The median volume of fluid aspirated was significantly lower in the axillary drainage group (0.00 ml; 0.00 – 270.00) compared to the no drain group (522.50 ml; 130.00 - 1148.75). The median number of aspirations performed during conservative breast cancer treatment was significantly lower in the drainage group (0.5; 0.0 - 4.0) compared to the no drain group (5.0; 3.0 - 7.0). The total volume of serous fluid produced (the volume of fluid obtained from drainage added to the volume of aspirated fluid) was similar in the two groups. Regarding complications, two cases (2.4%) of wound dehiscence occurred in the drainage group compared to 13 cases (13.5%) in the group in which drainage was not performed, with this difference being statistically significant. Rates of infection, necrosis and hematoma were similar in both groups.
Safety rates were similar in both study groups; hence, axillary dissection can feasibly be performed without drainage. However, more needle aspirations could be required, and there could be more cases of wound dehiscence in patients who do not undergo auxiliary drainage.
Url:
DOI: 10.6061/clinics/2017(07)07
PubMed: 28793003
PubMed Central: 5525160
Affiliations:
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Paulinelli</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-cln_72p426">Breast Program, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28793003</idno><idno type="pmc">5525160</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5525160</idno><idno type="RBID">PMC:5525160</idno><idno type="doi">10.6061/clinics/2017(07)07</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">003D59</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003D59</idno><idno 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first="Ruffo" last="Freitas-Junior">Ruffo Freitas-Junior</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-cln_72p426">Breast Program, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Ribeiro, Luis Fernando Jube" sort="Ribeiro, Luis Fernando Jube" uniqKey="Ribeiro L" first="Luís Fernando Jubé" last="Ribeiro">Luís Fernando Jubé Ribeiro</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Moreira, Marise Amaral Reboucas" sort="Moreira, Marise Amaral Reboucas" uniqKey="Moreira M" first="Marise Amaral Rebouças" last="Moreira">Marise Amaral Rebouças Moreira</name><affiliation><nlm:aff id="af3-cln_72p426">Department of Pathology, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Queiroz, Geraldo Silva" sort="Queiroz, Geraldo Silva" uniqKey="Queiroz G" first="Geraldo Silva" last="Queiroz">Geraldo Silva Queiroz</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Esperidiao, Mauricio Duarte" sort="Esperidiao, Mauricio Duarte" uniqKey="Esperidiao M" first="Maurício Duarte" last="Esperidião">Maurício Duarte Esperidião</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Silva, Marco Aurelio Costa" sort="Silva, Marco Aurelio Costa" uniqKey="Silva M" first="Marco Aurélio Costa" last="Silva">Marco Aurélio Costa Silva</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Pereira, Rubens Jose" sort="Pereira, Rubens Jose" uniqKey="Pereira R" first="Rubens José" last="Pereira">Rubens José Pereira</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Zampronha, Rossana Araujo Catao" sort="Zampronha, Rossana Araujo Catao" uniqKey="Zampronha R" first="Rossana Araújo Catão" last="Zampronha">Rossana Araújo Catão Zampronha</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Rahal, Rosemar Macedo Sousa" sort="Rahal, Rosemar Macedo Sousa" uniqKey="Rahal R" first="Rosemar Macedo Sousa" last="Rahal">Rosemar Macedo Sousa Rahal</name><affiliation><nlm:aff id="af2-cln_72p426">Breast Program, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Soares, Leonardo Ribeiro" sort="Soares, Leonardo Ribeiro" uniqKey="Soares L" first="Leonardo Ribeiro" last="Soares">Leonardo Ribeiro Soares</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Dos Santos, Danielle Laperche" sort="Dos Santos, Danielle Laperche" uniqKey="Dos Santos D" first="Danielle Laperche" last="Dos Santos">Danielle Laperche Dos Santos</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Thomazini, Maria Virginia" sort="Thomazini, Maria Virginia" uniqKey="Thomazini M" first="Maria Virginia" last="Thomazini">Maria Virginia Thomazini</name><affiliation><nlm:aff id="af2-cln_72p426">Breast Program, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="De Faria, Cassiana Ferreira Silva" sort="De Faria, Cassiana Ferreira Silva" uniqKey="De Faria C" first="Cassiana Ferreira Silva" last="De Faria">Cassiana Ferreira Silva De Faria</name><affiliation><nlm:aff id="af2-cln_72p426">Breast Program, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author><author><name sortKey="Paulinelli, Regis Resende" sort="Paulinelli, Regis Resende" uniqKey="Paulinelli R" first="Régis Resende" last="Paulinelli">Régis Resende Paulinelli</name><affiliation><nlm:aff id="af1-cln_72p426">Gynecology and Breast Unit, Hospital Araújo Jorge, Goiás Anticancer Association, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-cln_72p426">Breast Program, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, GO, BR</nlm:aff><wicri:noCountry code="subfield">BR</wicri:noCountry></affiliation></author></analytic><series><title level="j">Clinics</title><idno type="ISSN">1807-5932</idno><idno type="eISSN">1980-5322</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>OBJECTIVE:</title><p>This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection.</p></sec><sec><title>METHODS:</title><p>The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552.</p></sec><sec><title>RESULTS:</title><p>The median volume of fluid aspirated was significantly lower in the axillary drainage group (0.00 ml; 0.00 – 270.00) compared to the no drain group (522.50 ml; 130.00 - 1148.75). The median number of aspirations performed during conservative breast cancer treatment was significantly lower in the drainage group (0.5; 0.0 - 4.0) compared to the no drain group (5.0; 3.0 - 7.0). The total volume of serous fluid produced (the volume of fluid obtained from drainage added to the volume of aspirated fluid) was similar in the two groups. Regarding complications, two cases (2.4%) of wound dehiscence occurred in the drainage group compared to 13 cases (13.5%) in the group in which drainage was not performed, with this difference being statistically significant. Rates of infection, necrosis and hematoma were similar in both groups.</p></sec><sec><title>CONCLUSION:</title><p>Safety rates were similar in both study groups; hence, axillary dissection can feasibly be performed without drainage. However, more needle aspirations could be required, and there could be more cases of wound dehiscence in patients who do not undergo auxiliary drainage.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Freitas Junior, R" uniqKey="Freitas Junior R">R Freitas-Júnior</name></author><author><name sortKey="Oliveira, El" uniqKey="Oliveira E">EL Oliveira</name></author><author><name sortKey="Pereira, Rj" uniqKey="Pereira R">RJ Pereira</name></author><author><name sortKey="Silva, Ma" uniqKey="Silva M">MA Silva</name></author><author><name sortKey="Esperidiao, Md" uniqKey="Esperidiao M">MD Esperidião</name></author><author><name sortKey="Zampronha, Ra" uniqKey="Zampronha R">RA Zampronha</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jagsi, R" uniqKey="Jagsi R">R Jagsi</name></author><author><name sortKey="Jiang, J" uniqKey="Jiang J">J Jiang</name></author><author><name sortKey="Momoh, Ao" 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sort="Dos Santos, Danielle Laperche" uniqKey="Dos Santos D" first="Danielle Laperche" last="Dos Santos">Danielle Laperche Dos Santos</name><name sortKey="Esperidiao, Mauricio Duarte" sort="Esperidiao, Mauricio Duarte" uniqKey="Esperidiao M" first="Maurício Duarte" last="Esperidião">Maurício Duarte Esperidião</name><name sortKey="Freitas Junior, Ruffo" sort="Freitas Junior, Ruffo" uniqKey="Freitas Junior R" first="Ruffo" last="Freitas-Junior">Ruffo Freitas-Junior</name><name sortKey="Moreira, Marise Amaral Reboucas" sort="Moreira, Marise Amaral Reboucas" uniqKey="Moreira M" first="Marise Amaral Rebouças" last="Moreira">Marise Amaral Rebouças Moreira</name><name sortKey="Paulinelli, Regis Resende" sort="Paulinelli, Regis Resende" uniqKey="Paulinelli R" first="Régis Resende" last="Paulinelli">Régis Resende Paulinelli</name><name sortKey="Pereira, Rubens Jose" sort="Pereira, Rubens Jose" uniqKey="Pereira R" first="Rubens José" last="Pereira">Rubens José Pereira</name><name sortKey="Queiroz, Geraldo Silva" sort="Queiroz, Geraldo Silva" uniqKey="Queiroz G" first="Geraldo Silva" last="Queiroz">Geraldo Silva Queiroz</name><name sortKey="Rahal, Rosemar Macedo Sousa" sort="Rahal, Rosemar Macedo Sousa" uniqKey="Rahal R" first="Rosemar Macedo Sousa" last="Rahal">Rosemar Macedo Sousa Rahal</name><name sortKey="Ribeiro, Luis Fernando Jube" sort="Ribeiro, Luis Fernando Jube" uniqKey="Ribeiro L" first="Luís Fernando Jubé" last="Ribeiro">Luís Fernando Jubé Ribeiro</name><name sortKey="Silva, Marco Aurelio Costa" sort="Silva, Marco Aurelio Costa" uniqKey="Silva M" first="Marco Aurélio Costa" last="Silva">Marco Aurélio Costa Silva</name><name sortKey="Soares, Leonardo Ribeiro" sort="Soares, Leonardo Ribeiro" uniqKey="Soares L" first="Leonardo Ribeiro" last="Soares">Leonardo Ribeiro Soares</name><name sortKey="Thomazini, Maria Virginia" sort="Thomazini, Maria Virginia" uniqKey="Thomazini M" first="Maria Virginia" last="Thomazini">Maria Virginia Thomazini</name><name sortKey="Zampronha, Rossana Araujo Catao" sort="Zampronha, Rossana Araujo Catao" uniqKey="Zampronha R" first="Rossana Araújo Catão" last="Zampronha">Rossana Araújo Catão Zampronha</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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