Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
The Relationship Between Drain Removal Day and Breast Weight in Patients with Breast Cancer After Mastectomy: A Retrospective Study
Mastektomi Sonrası Meme Kanserli Hastalarda Dren Alma Günü ile Meme Ağırlığı Arasındaki İlişki: Retrospektif Bir Çalışma
Şeref DOKCUa, Mehmet Ali ÇAPARLARa, Özhan ÇETİNDAĞa, Aydan EROĞLUa
aDepartment of Oncological Surgery, Ankara University Faculty of Medicine, Ankara, Türkiye
Turkiye Klinikleri J Med Sci. 2022;42(3):178-82
doi: 10.5336/medsci.2021-84896
Article Language: EN
Full Text
ABSTRACT
 Objective: Surgeries performed for breast cancer often include wide flap practices and breast tissue resections. This condition paves the way for bothersome complications such as seroma, which negatively affect patient comfort and also require hospitalization. Hence, surgeons have adopted postoperative drain application as an indispensable routine. In this study, we aimed to examine the relationship between the weight of resected breast tissue after mastectomy and the postoperative drain removal time. Material and Methods: Retrospective medical records of 107 patients who underwent mastectomy procedures due to breast cancer in the surgical oncology clinic were exported from the hospital database. Statistical analyzes were performed within the confidence interval of 95%. A p value less than 0.05 was considered statistically significant. Results: The mean age of the patients was 55.13, mean body mass index was 28, mean day of drain removal was 8.45, mean number of lymph nodes removed was 12. Only 47% of the patients had metastatic lymph nodes, with an average of 4.6. We found that the time of drain removal was longer in patients who underwent modified radical mastectomy (MRM) and had axillary lymphatic involvement (p=0.00). In the correlation analysis performed, there was a positive correlation between postoperative drain removal time and breast weight (p=0.00), the total number of lymph nodes removed (p=0.00), number of metastatic lymph nodes (p=0.04), and body mass index (p=0.004). Conclusion: Our results are consistent with the current literature, and we recommend being more persistent for drainage practice in patients with axillary involvement, who are overweight and have large breast volumes, and not ignoring individual risks in clinical practice.

Keywords: Body mass index; breast neoplasms; drainage; mastectomy; seroma
ÖZET
 Amaç: Meme kanseri nedeniyle yapılan ameliyatlar çoğu zaman geniş flep uygulamaları ve meme dokusu rezeksiyonlarını içerir. Bu durum, ameliyat sonrası hem hasta konforunu olumsuz etkileyen hem de hastaneye yeniden yatış gerektiren seroma gibi can sıkıcı komplikasyonlara zemin hazırlar. Bu yüzden cerrahlar, ameliyat sonrası dren uygulamasını vazgeçilmez bir rutinleri olarak benimsemişlerdir. Bu çalışmamızda, mastektomi sonrası rezeke edilen meme dokusunun ağırlığı ile postoperatif dren çekim zamanı arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve Yöntemler: Cerrahi onkoloji kliniğinde meme kanseri nedeni ile mastektomi prosedürü uygulanan 107 hastanın retrospektif olarak tıbbi kayıtları hastane veri tabanından çıkarıldı. İstatistiksel analizler %95 güven aralığında yapıldı. p değerinin 0,05'ten küçük olması istatistiksel olarak anlamlı kabul edildi. Bulgular: Hastaların yaş ortalaması 55,13, beden kitle indeksi ortalamaları 28, dren alan günü ortalamaları 8,45, çıkarılan lenf nodu sayısı ortalama 12 idi. Hastaların sadece %47'sinde metastatik lenf nodu mevcut olup ortalama 4,6 adet idi. Dren çekim zamanını modifiye radikal mastektomi (MRM) yapılan ve aksiller lenfatik tutulum gösteren hastalarda daha uzun bulduk (p=0,00). Yapılan korelasyon analizlerinde ise postoperatif dren çekim zamanı ile meme ağırlığı (p=0,00), total çıkarılan lenf nodu sayısı (p=0,00), metastatik lenf nodu sayısı (p=0,04) ve beden kitle indeksi (p=0,004) arasında pozitif yönde ilişki mevcuttu. Sonuç: Sonuçlarımız güncel literatürle uyumlu olup, klinik uygulamada MRM yapılacak, aksiller tutulum gösteren, kilolu ve büyük meme hacimlerine sahip hastalarda drenaj için daha ısrarlı davranmayı ve bireysel riskleri göz ardı etmemeyi tavsiye ediyoruz.

Anahtar Kelimeler: Beden kitle indeksi; meme neoplazileri; drenaj; mastektomi; seroma
REFERENCES:
  1. DeSantis C, Ma J, Bryan L, Jemal A. Breast cancer statistics, 2013. CA Cancer J Clin. 2014;64(1):52-62. [Crossref]  [PubMed] 
  2. Thomson DR, Sadideen H, Furniss D. Wound drainage after axillary dissection for carcinoma of the breast. Cochrane Database Syst Rev. 2013;2013(10):CD006823. [PubMed]  [PMC] 
  3. He XD, Guo ZH, Tian JH, Yang KH, Xie XD. Whether drainage should be used after surgery for breast cancer? A systematic review of randomized controlled trials. Med Oncol. 2011;28 Suppl 1:S22-30. [Crossref]  [PubMed] 
  4. Isozaki H, Yamamoto Y, Murakami S, Matsumoto S, Takama T. Impact of the surgical modality for axillary lymph node dissection on postoperative drainage and seroma formation after total mastectomy. Patient Saf Surg. 2019;13:20. [Crossref]  [PubMed]  [PMC] 
  5. Douay N, Akerman G, Clément D, Malartic C, Morel O, Barranger E. Prise en charge des lymphocèles après curage axillaire dans le cancer du sein [Seroma after axillary lymph node dissection in breast cancer]. Gynecol Obstet Fertil. 2008;36(2):130-5. French. [Crossref]  [PubMed] 
  6. Kottayasamy Seenivasagam R, Gupta V, Singh G. Prevention of seroma formation after axillary dissection--a comparative randomized clinical trial of three methods. Breast J. 2013;19(5):478-84. [Crossref]  [PubMed] 
  7. Taylor JC, Rai S, Hoar F, Brown H, Vishwanath L. Breast cancer surgery without suction drainage: the impact of adopting a 'no drains' policy on symptomatic seroma formation rates. Eur J Surg Oncol. 2013;39(4):334-8. [Crossref]  [PubMed] 
  8. Baas-Vrancken Peeters MJ, Kluit AB, Merkus JW, Breslau PJ. Short versus long-term postoperative drainage of the axilla after axillary lymph node dissection. A prospective randomized study. Breast Cancer Res Treat. 2005;93(3):271-5. [Crossref]  [PubMed] 
  9. Liu CD, McFadden DW. Overnight closed suction drainage after axillary lymphadenectomy for breast cancer. Am Surg. 1997;63(10):868-70. [PubMed] 
  10. Iida S, Furukawa K, Yanagihara K, Iwasaki R, Kurita T, Tsuchiya S, et al. An analysis of factors that influence the duration of suction drainage in breast cancer surgery. J Nippon Med Sch. 2008;75(6):332-6. [Crossref]  [PubMed] 
  11. Uslukaya Ö, Türkoğlu A, Gümüş M, Bozdağ Z, Yılmaz A, Gümüş H, et al. Factors that affect drain indwelling time after breast cancer surgery. J Breast Health. 2016;12(3):102-6. [Crossref]  [PubMed]  [PMC] 
  12. Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Evidence-based risk factors for seroma formation in breast surgery. Jpn J Clin Oncol. 2006;36(4):197-206. [Crossref]  [PubMed] 
  13. Lim YM, Lew DH, Roh TS, Song SY. Analysis of factors that affect drainage volume after expander-based breast reconstruction. Arch Plast Surg. 2020;47(1):33-41. [Crossref]  [PubMed]  [PMC] 
  14. Andeweg CS, Schriek MJ, Heisterkamp J, Roukema JA. Seroma formation in two cohorts after axillary lymph node dissection in breast cancer surgery: does timing of drain removal matter? Breast J. 2011;17(4):359-64. [Crossref]  [PubMed] 
  15. Troost MS, Kempees CJ, de Roos MAJ. Breast cancer surgery without drains: no influence on seroma formation. Int J Surg. 2015;13:170-4. [Crossref]  [PubMed] 
  16. Petrek JA, Peters MM, Cirrincione C, Thaler HT. A prospective randomized trial of single versus multiple drains in the axilla after lymphadenectomy. Surg Gynecol Obstet. 1992;175(5):405-9. [PubMed] 
  17. Terrell GS, Singer JA. Axillary versus combined axillary and pectoral drainage after modified radical mastectomy. Surg Gynecol Obstet. 1992;175(5):437-40. [PubMed] 
  18. Bonnema J, van Geel AN, Ligtenstein DA, Schmitz PI, Wiggers T. A prospective randomized trial of high versus low vacuum drainage after axillary dissection for breast cancer. Am J Surg. 1997;173(2):76-9. [Crossref]  [PubMed] 
  19. Stoyanov GS, Tsocheva D, Marinova K, Dobrev E, Nenkov R. Drainage after modified radical mastectomy - a methodological mini-review. Cureus. 2017;9(7):e1454. [Crossref]  [PubMed]  [PMC] 
  20. Ezeome ER, Adebamowo CA. Closed suction drainage versus closed simple drainage in the management of modified radical mastectomy wounds. S Afr Med J. 2008;98(9):712-5. [PubMed] 
  21. Saratzis A, Soumian S, Willetts R, Rastall S, Stonelake PS. Use of multiple drains after mastectomy is associated with more patient discomfort and longer postoperative stay. Clin Breast Cancer. 2009;9(4):243-6. [Crossref]  [PubMed] 
  22. Ebner FK, Friedl TW, Degregorio N, Reich A, Janni W, Rempen A. Does non-placement of a drain in breast surgery ıncrease the rate of complications and revisions? Geburtshilfe Frauenheilkd. 2013;73(11):1128-34. [Crossref]  [PubMed]  [PMC] 

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