Does Non-Placement of a Drain in Breast Surgery Increase the Rate of Complications and Revisions?
Identifieur interne : 000048 ( Pmc/Corpus ); précédent : 000047; suivant : 000049Does Non-Placement of a Drain in Breast Surgery Increase the Rate of Complications and Revisions?
Auteurs : F. K. Ebner ; T. W. P. Friedl ; N. Degregorio ; A. Reich ; W. Janni ; A. RempenSource :
- Geburtshilfe und Frauenheilkunde [ 0016-5751 ] ; 2013.
Abstract
Url:
DOI: 10.1055/s-0033-1351071
PubMed: 24771899
PubMed Central: 3862046
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PMC:3862046Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Does Non-Placement of a Drain in Breast Surgery Increase the Rate of
Complications and Revisions?</title>
<author><name sortKey="Ebner, F K" sort="Ebner, F K" uniqKey="Ebner F" first="F. K." last="Ebner">F. K. Ebner</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Friedl, T W P" sort="Friedl, T W P" uniqKey="Friedl T" first="T. W. P." last="Friedl">T. W. P. Friedl</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Degregorio, N" sort="Degregorio, N" uniqKey="Degregorio N" first="N." last="Degregorio">N. Degregorio</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Reich, A" sort="Reich, A" uniqKey="Reich A" first="A." last="Reich">A. Reich</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Janni, W" sort="Janni, W" uniqKey="Janni W" first="W." last="Janni">W. Janni</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rempen, A" sort="Rempen, A" uniqKey="Rempen A" first="A." last="Rempen">A. Rempen</name>
<affiliation><nlm:aff id="AF684-2"><institution>Frauenklinik, Diakonieklinikum, Schwäbisch Hall</institution>
</nlm:aff>
</affiliation>
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<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">24771899</idno>
<idno type="pmc">3862046</idno>
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<idno type="doi">10.1055/s-0033-1351071</idno>
<date when="2013">2013</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Does Non-Placement of a Drain in Breast Surgery Increase the Rate of
Complications and Revisions?</title>
<author><name sortKey="Ebner, F K" sort="Ebner, F K" uniqKey="Ebner F" first="F. K." last="Ebner">F. K. Ebner</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Friedl, T W P" sort="Friedl, T W P" uniqKey="Friedl T" first="T. W. P." last="Friedl">T. W. P. Friedl</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Degregorio, N" sort="Degregorio, N" uniqKey="Degregorio N" first="N." last="Degregorio">N. Degregorio</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Reich, A" sort="Reich, A" uniqKey="Reich A" first="A." last="Reich">A. Reich</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Janni, W" sort="Janni, W" uniqKey="Janni W" first="W." last="Janni">W. Janni</name>
<affiliation><nlm:aff id="AF684-1"><institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rempen, A" sort="Rempen, A" uniqKey="Rempen A" first="A." last="Rempen">A. Rempen</name>
<affiliation><nlm:aff id="AF684-2"><institution>Frauenklinik, Diakonieklinikum, Schwäbisch Hall</institution>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Geburtshilfe und Frauenheilkunde</title>
<idno type="ISSN">0016-5751</idno>
<idno type="eISSN">1438-8804</idno>
<imprint><date when="2013">2013</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><p><bold>Purpose:</bold>
Although surgical therapy for breast cancer has become less
radical, intrasurgical placement of drains and the use of compression
bandages is still standard practice. However, evidence for the clinical
benefit of wound drains is controversial, and use of drains is associated
with increased pain and longer hospital stays. This raises the question
whether, given the latest surgical techniques, wound drainage is still
medically necessary.
<bold>Material and Method:</bold>
A retrospective
analysis was done of patients with breast cancer treated surgically between
January 2009 and April 2012 in the Breast Centre Hohenlohe (n = 573).
Complication rates and revision following surgery with and without placement
of wound drains were compared for patients who had breast-conserving surgery
(n = 425) and patients who underwent mastectomy
(n = 148).
<bold>Results:</bold>
The baseline characteristics (age,
number of resected lymph nodes, numbers of patients who had sentinel lymph
node resection, tumour characteristics, receptor status and affected side)
were comparable for the investigated patient groups. The overall rate of
complications was 4 %. There was no significant difference with regard to
complication rates after surgery with and without placement of wound drains
between the group of patients with breast-conserving surgery and the group
of patients with mastectomy (p = 0.68 and p = 0.54,
respectively).
<bold>Conclusion:</bold>
Our data indicate that
non-placement of a wound drain does not influence complication or revision
rates after breast-conserving surgery or mastectomy.</p>
</div>
</front>
</TEI>
<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">Geburtshilfe Frauenheilkd</journal-id>
<journal-id journal-id-type="iso-abbrev">Geburtshilfe Frauenheilkd</journal-id>
<journal-id journal-id-type="doi">10.1055/s-00000020</journal-id>
<journal-title-group><journal-title>Geburtshilfe und Frauenheilkunde</journal-title>
</journal-title-group>
<issn pub-type="ppub">0016-5751</issn>
<issn pub-type="epub">1438-8804</issn>
<publisher><publisher-name>Georg Thieme Verlag KG</publisher-name>
<publisher-loc>Stuttgart · New York</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24771899</article-id>
<article-id pub-id-type="pmc">3862046</article-id>
<article-id pub-id-type="doi">10.1055/s-0033-1351071</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Does Non-Placement of a Drain in Breast Surgery Increase the Rate of
Complications and Revisions?</article-title>
<trans-title-group xml:lang="de"><trans-title>Erhöht der Verzicht auf die Drainage bei Brustoperationen
wegen eines Karzinoms die Rate an Komplikationen und
Revisionsoperationen?</trans-title>
</trans-title-group>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ebner</surname>
<given-names>F. K.</given-names>
</name>
<xref rid="AF684-1" ref-type="aff">1</xref>
<xref rid="CO-1" ref-type="author-notes"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Friedl</surname>
<given-names>T. W. P.</given-names>
</name>
<xref rid="AF684-1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>deGregorio</surname>
<given-names>N.</given-names>
</name>
<xref rid="AF684-1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Reich</surname>
<given-names>A.</given-names>
</name>
<xref rid="AF684-1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Janni</surname>
<given-names>W.</given-names>
</name>
<xref rid="AF684-1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rempen</surname>
<given-names>A.</given-names>
</name>
<xref rid="AF684-2" ref-type="aff">2</xref>
</contrib>
</contrib-group>
<aff id="AF684-1"><label>1</label>
<institution>Frauenklinik, Universitätsklinik, Ulm</institution>
</aff>
<aff id="AF684-2"><label>2</label>
<institution>Frauenklinik, Diakonieklinikum, Schwäbisch Hall</institution>
</aff>
<author-notes><corresp id="CO-1"><bold>Correspondence </bold>
Dr. Florian K. Ebner, MD <institution>Universitätsklinik, Frauenklinik</institution>
<addr-line>Prittwitzstraße 43</addr-line>
<addr-line>89075 Ulm</addr-line>
<email>dr.ebner@web.de</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2013</year>
</pub-date>
<volume>73</volume>
<issue>11</issue>
<fpage>1128</fpage>
<lpage>1134</lpage>
<history><date date-type="received"><day>28</day>
<month>10</month>
<year>2012</year>
</date>
<date date-type="rev-recd"><day>19</day>
<month>8</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>20</day>
<month>8</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© Thieme Medical Publishers</copyright-statement>
</permissions>
<abstract><p><bold>Purpose:</bold>
Although surgical therapy for breast cancer has become less
radical, intrasurgical placement of drains and the use of compression
bandages is still standard practice. However, evidence for the clinical
benefit of wound drains is controversial, and use of drains is associated
with increased pain and longer hospital stays. This raises the question
whether, given the latest surgical techniques, wound drainage is still
medically necessary.
<bold>Material and Method:</bold>
A retrospective
analysis was done of patients with breast cancer treated surgically between
January 2009 and April 2012 in the Breast Centre Hohenlohe (n = 573).
Complication rates and revision following surgery with and without placement
of wound drains were compared for patients who had breast-conserving surgery
(n = 425) and patients who underwent mastectomy
(n = 148).
<bold>Results:</bold>
The baseline characteristics (age,
number of resected lymph nodes, numbers of patients who had sentinel lymph
node resection, tumour characteristics, receptor status and affected side)
were comparable for the investigated patient groups. The overall rate of
complications was 4 %. There was no significant difference with regard to
complication rates after surgery with and without placement of wound drains
between the group of patients with breast-conserving surgery and the group
of patients with mastectomy (p = 0.68 and p = 0.54,
respectively).
<bold>Conclusion:</bold>
Our data indicate that
non-placement of a wound drain does not influence complication or revision
rates after breast-conserving surgery or mastectomy.</p>
</abstract>
<trans-abstract xml:lang="de"><sec><title>Zusammenfassung</title>
<p><bold>Problem:</bold>
Trotz der verringerten Radikalität der operativen Therapie
des Mammakarzinoms werden häufig routinemäßig Redon-Drainagen angelegt. Der
medizinische Nutzen von Drainage ist allerdings nicht unumstritten.
Drainageneinlagen sind mit vermehrten Schmerzen und einer Verlängerung des
stationären Aufenthalts verbunden. Somit stellt sich die Frage, ob eine
Redon-Drainage in Anbetracht der aktuellen Operationstechniken heute noch
medizinisch notwendig ist.
<bold>Material und Methode:</bold>
In einer
retrospektiven Analyse der im Zeitraum Januar 2009 – April 2012 operativ
behandelten Mammakarzinompatientinnen des Brustzentrums Hohenlohe (n = 573)
wurden Komplikations- und Revisionsraten zwischen Operationen mit und ohne
Drainageneinlage sowohl für Patientinnen mit brusterhaltender Operation
(n = 425) als auch für Patientinnen mit Mastektomie (n = 148)
verglichen.
<bold>Ergebnisse:</bold>
Die untersuchten
Patientinnengruppen waren in Bezug auf Alter, entfernte Lymphknoten,
Häufigkeit der Wächterlymphknotenentfernung, Tumoreigenschaften,
Rezeptorstatus und Seitenverteilung vergleichbar. Die Komplikationsrate für
das Gesamtkollektiv betrug 4 %. Weder für die Gruppe der Patientinnen mit
brusterhaltender Operation noch für die Gruppe der Patientinnen mit
Mastektomie gab es einen signifikanten Unterschied in der Häufigkeit des
Auftretens von Komplikationen nach Operationen mit und ohne Drainageneinlage
(p = 0,68; bzw. p = 0,54).
<bold>Schlussfolgerung:</bold>
Unsere Daten
deuten an, dass der Verzicht auf eine Drainageneinlage sowohl bei
brusterhaltenden Operationen als auch bei Mastektomie nicht zu einer
erhöhten Rate von konservativ behandelten Komplikationen und
Revisionsoperationen führt.</p>
</sec>
</trans-abstract>
<kwd-group xml:lang="en"><title>Key words</title>
<kwd>breast cancer</kwd>
<kwd>breast</kwd>
<kwd>breast malignancy</kwd>
<kwd>complication</kwd>
<kwd>drainage</kwd>
<kwd>seroma</kwd>
</kwd-group>
<kwd-group xml:lang="de"><title>Schlüsselwörter</title>
<kwd>Mammakarzinom</kwd>
<kwd>Mamma</kwd>
<kwd>Mammamalignom</kwd>
<kwd>Komplikation</kwd>
<kwd>Drainage</kwd>
<kwd>Serom</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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