Is it really useful the Harmonic scalpel in axillary dissection for locally advanced breast cancer? A case series
Identifieur interne : 000224 ( Pmc/Checkpoint ); précédent : 000223; suivant : 000225Is it really useful the Harmonic scalpel in axillary dissection for locally advanced breast cancer? A case series
Auteurs : G. Militello ; P. De Marco ; N. Falco ; K. Kabhuli ; A. Mascolino ; L. Licari ; R. Tutino ; G. Cocorullo ; G. GulottaSource :
- Il Giornale di Chirurgia [ 0391-9005 ] ; 2017.
Abstract
The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique.
From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection. Each group consisted of 60 patients. Quadrantectomy (QUAD) was performed in 54 patients, 66 women underwent mastectomy. In all patients axillary dissection included the I, II and III level. We compared two groups in terms of: time of surgery, hematoma, drainage volume, days of sealing drainage, seroma formation, number of post-seroma aspirations, upper limb lymphedema, wound infections, post-operative pain.
Statistically significant results were obtained in terms of the total volume of the breast and axillary drainage in the two techniques. There were no significant differences in the two samples in terms of operative time incidence of seroma, post-operative hematoma, wound infection, and lymphedema of the upper limb.
The small number of cases did not allow us to reach definitive conclusions. The use of Harmonic scalpel seems to show smaller incidence of seroma and reduction of the amount of both breast and axillary drainages. Further studies are needed to define the real advantage in terms of cost benefit of using these devices in the axillary surgery.
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DOI: 10.11138/gchir/2016.37.6.262
PubMed: 28350973
PubMed Central: 5505484
Affiliations:
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<author><name sortKey="Militello, G" sort="Militello, G" uniqKey="Militello G" first="G." last="Militello">G. Militello</name>
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<author><name sortKey="De Marco, P" sort="De Marco, P" uniqKey="De Marco P" first="P." last="De Marco">P. De Marco</name>
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<author><name sortKey="Falco, N" sort="Falco, N" uniqKey="Falco N" first="N." last="Falco">N. Falco</name>
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<author><name sortKey="Kabhuli, K" sort="Kabhuli, K" uniqKey="Kabhuli K" first="K." last="Kabhuli">K. Kabhuli</name>
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<author><name sortKey="Mascolino, A" sort="Mascolino, A" uniqKey="Mascolino A" first="A." last="Mascolino">A. Mascolino</name>
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<author><name sortKey="Licari, L" sort="Licari, L" uniqKey="Licari L" first="L." last="Licari">L. Licari</name>
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<author><name sortKey="Tutino, R" sort="Tutino, R" uniqKey="Tutino R" first="R." last="Tutino">R. Tutino</name>
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<author><name sortKey="Cocorullo, G" sort="Cocorullo, G" uniqKey="Cocorullo G" first="G." last="Cocorullo">G. Cocorullo</name>
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<author><name sortKey="Gulotta, G" sort="Gulotta, G" uniqKey="Gulotta G" first="G." last="Gulotta">G. Gulotta</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Is it really useful the Harmonic scalpel in axillary dissection for locally advanced breast cancer? A case series</title>
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<author><name sortKey="De Marco, P" sort="De Marco, P" uniqKey="De Marco P" first="P." last="De Marco">P. De Marco</name>
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<author><name sortKey="Falco, N" sort="Falco, N" uniqKey="Falco N" first="N." last="Falco">N. Falco</name>
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<author><name sortKey="Kabhuli, K" sort="Kabhuli, K" uniqKey="Kabhuli K" first="K." last="Kabhuli">K. Kabhuli</name>
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<author><name sortKey="Mascolino, A" sort="Mascolino, A" uniqKey="Mascolino A" first="A." last="Mascolino">A. Mascolino</name>
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<author><name sortKey="Licari, L" sort="Licari, L" uniqKey="Licari L" first="L." last="Licari">L. Licari</name>
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<author><name sortKey="Tutino, R" sort="Tutino, R" uniqKey="Tutino R" first="R." last="Tutino">R. Tutino</name>
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<author><name sortKey="Cocorullo, G" sort="Cocorullo, G" uniqKey="Cocorullo G" first="G." last="Cocorullo">G. Cocorullo</name>
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<series><title level="j">Il Giornale di Chirurgia</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique.</p>
</sec>
<sec><title>Patients and Methods</title>
<p>From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection. Each group consisted of 60 patients. Quadrantectomy (QUAD) was performed in 54 patients, 66 women underwent mastectomy. In all patients axillary dissection included the I, II and III level. We compared two groups in terms of: time of surgery, hematoma, drainage volume, days of sealing drainage, seroma formation, number of post-seroma aspirations, upper limb lymphedema, wound infections, post-operative pain.</p>
</sec>
<sec><title>Results</title>
<p>Statistically significant results were obtained in terms of the total volume of the breast and axillary drainage in the two techniques. There were no significant differences in the two samples in terms of operative time incidence of seroma, post-operative hematoma, wound infection, and lymphedema of the upper limb.</p>
</sec>
<sec><title>Conclusion</title>
<p>The small number of cases did not allow us to reach definitive conclusions. The use of Harmonic scalpel seems to show smaller incidence of seroma and reduction of the amount of both breast and axillary drainages. Further studies are needed to define the real advantage in terms of cost benefit of using these devices in the axillary surgery.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">G Chir</journal-id>
<journal-id journal-id-type="iso-abbrev">G Chir</journal-id>
<journal-title-group><journal-title>Il Giornale di Chirurgia</journal-title>
</journal-title-group>
<issn pub-type="ppub">0391-9005</issn>
<issn pub-type="epub">1971-145X</issn>
<publisher><publisher-name>CIC Edizioni Internazionali</publisher-name>
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<article-meta><article-id pub-id-type="pmid">28350973</article-id>
<article-id pub-id-type="pmc">5505484</article-id>
<article-id pub-id-type="doi">10.11138/gchir/2016.37.6.262</article-id>
<article-id pub-id-type="publisher-id">262-265</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Is it really useful the Harmonic scalpel in axillary dissection for locally advanced breast cancer? A case series</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>MILITELLO</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>DE MARCO</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>FALCO</surname>
<given-names>N.</given-names>
</name>
<xref ref-type="corresp" rid="c1-262-265"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>KABHULI</surname>
<given-names>K.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>MASCOLINO</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>LICARI</surname>
<given-names>L.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>TUTINO</surname>
<given-names>R.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>COCORULLO</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>GULOTTA</surname>
<given-names>G.</given-names>
</name>
</contrib>
<aff id="af1-262-265">Department of Surgical, Oncological and Oral Sciences, University of Palermo, General Surgery and Emergency Operative Unit, “Policlinico Universitario P. Giaccone”, Palermo, Italy</aff>
</contrib-group>
<author-notes><corresp id="c1-262-265">Corresponding author: Nicolò Falco, e-mail: <email>nicola.falco87@libero.it</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><season>Nov-Dec</season>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>29</day>
<month>3</month>
<year>2017</year>
</pub-date>
<volume>37</volume>
<issue>6</issue>
<fpage>262</fpage>
<lpage>265</lpage>
<permissions><copyright-statement>Copyright © 2016, CIC Edizioni Internazionali</copyright-statement>
<copyright-year>2016</copyright-year>
</permissions>
<abstract><sec><title>Background</title>
<p>The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique.</p>
</sec>
<sec><title>Patients and Methods</title>
<p>From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection. Each group consisted of 60 patients. Quadrantectomy (QUAD) was performed in 54 patients, 66 women underwent mastectomy. In all patients axillary dissection included the I, II and III level. We compared two groups in terms of: time of surgery, hematoma, drainage volume, days of sealing drainage, seroma formation, number of post-seroma aspirations, upper limb lymphedema, wound infections, post-operative pain.</p>
</sec>
<sec><title>Results</title>
<p>Statistically significant results were obtained in terms of the total volume of the breast and axillary drainage in the two techniques. There were no significant differences in the two samples in terms of operative time incidence of seroma, post-operative hematoma, wound infection, and lymphedema of the upper limb.</p>
</sec>
<sec><title>Conclusion</title>
<p>The small number of cases did not allow us to reach definitive conclusions. The use of Harmonic scalpel seems to show smaller incidence of seroma and reduction of the amount of both breast and axillary drainages. Further studies are needed to define the real advantage in terms of cost benefit of using these devices in the axillary surgery.</p>
</sec>
</abstract>
<kwd-group><kwd>Harmonic scalpel</kwd>
<kwd>Axillary dissection</kwd>
<kwd>Breast Cancer</kwd>
<kwd>Volume drainage</kwd>
</kwd-group>
</article-meta>
</front>
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<affiliations><list></list>
<tree><noCountry><name sortKey="Cocorullo, G" sort="Cocorullo, G" uniqKey="Cocorullo G" first="G." last="Cocorullo">G. Cocorullo</name>
<name sortKey="De Marco, P" sort="De Marco, P" uniqKey="De Marco P" first="P." last="De Marco">P. De Marco</name>
<name sortKey="Falco, N" sort="Falco, N" uniqKey="Falco N" first="N." last="Falco">N. Falco</name>
<name sortKey="Gulotta, G" sort="Gulotta, G" uniqKey="Gulotta G" first="G." last="Gulotta">G. Gulotta</name>
<name sortKey="Kabhuli, K" sort="Kabhuli, K" uniqKey="Kabhuli K" first="K." last="Kabhuli">K. Kabhuli</name>
<name sortKey="Licari, L" sort="Licari, L" uniqKey="Licari L" first="L." last="Licari">L. Licari</name>
<name sortKey="Mascolino, A" sort="Mascolino, A" uniqKey="Mascolino A" first="A." last="Mascolino">A. Mascolino</name>
<name sortKey="Militello, G" sort="Militello, G" uniqKey="Militello G" first="G." last="Militello">G. Militello</name>
<name sortKey="Tutino, R" sort="Tutino, R" uniqKey="Tutino R" first="R." last="Tutino">R. Tutino</name>
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