Intraoperative and postoperative outcomes of Harmonic Focus versus monopolar electrocautery after neoadjuvant chemotherapy in breast conservative surgery: a comparative study.
Breast cancer
Conservative surgery
Harmonic scalpel
Neoadjuvant chemotherapy
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
15 Nov 2021
15 Nov 2021
Historique:
received:
18
08
2021
accepted:
01
11
2021
entrez:
16
11
2021
pubmed:
17
11
2021
medline:
18
11
2021
Statut:
epublish
Résumé
Surgical devices are commonly used during breast conservative surgery (BCS) to provide better hemostasis. The Harmonic scalpel has recently gained momentum as an effective tool for intraoperative bleeding reduction. This comparative study was designed to determine the efficacy of Harmonic Focus in reducing postoperative complications of BCS after neoadjuvant chemotherapy (CTH) compared to the conventional method using monopolar diathermy. A prospective, nonrandomized, comparative study was conducted on patients scheduled to undergo BCS with axillary dissection after neoadjuvant CTH. Patients in the Harmonic Focus group had significantly shorter operative times than the monopolar electrocautery group (101.32 ± 27.3 vs. 139.3 ± 31.9 min, respectively; p < 0.001). Besides, blood loss was significantly lower in the Harmonic Focus group (117.14 ± 35.6 vs. 187 ± 49.8 mL, respectively; p < 0.001). Postoperatively, patients in the Harmonic Focus group had a significantly lower volume of chest wall drain (p < 0.001) and shorter time until drain removal (p < 0.001). Likewise, patients in the Harmonic Focus group had a significantly lower volume of axillary drain and shorter time until drain removal than monopolar electrocautery (p < 0.001). The incidence of postoperative complications was comparable between both groups (p = 0.128). This study confirmed the superiority of Harmonic Focus compared to monopolar electrocautery among patients receiving neoadjuvant CTH before BCS.
Sections du résumé
BACKGROUND
BACKGROUND
Surgical devices are commonly used during breast conservative surgery (BCS) to provide better hemostasis. The Harmonic scalpel has recently gained momentum as an effective tool for intraoperative bleeding reduction. This comparative study was designed to determine the efficacy of Harmonic Focus in reducing postoperative complications of BCS after neoadjuvant chemotherapy (CTH) compared to the conventional method using monopolar diathermy.
RESULTS
RESULTS
A prospective, nonrandomized, comparative study was conducted on patients scheduled to undergo BCS with axillary dissection after neoadjuvant CTH. Patients in the Harmonic Focus group had significantly shorter operative times than the monopolar electrocautery group (101.32 ± 27.3 vs. 139.3 ± 31.9 min, respectively; p < 0.001). Besides, blood loss was significantly lower in the Harmonic Focus group (117.14 ± 35.6 vs. 187 ± 49.8 mL, respectively; p < 0.001). Postoperatively, patients in the Harmonic Focus group had a significantly lower volume of chest wall drain (p < 0.001) and shorter time until drain removal (p < 0.001). Likewise, patients in the Harmonic Focus group had a significantly lower volume of axillary drain and shorter time until drain removal than monopolar electrocautery (p < 0.001). The incidence of postoperative complications was comparable between both groups (p = 0.128).
CONCLUSIONS
CONCLUSIONS
This study confirmed the superiority of Harmonic Focus compared to monopolar electrocautery among patients receiving neoadjuvant CTH before BCS.
Identifiants
pubmed: 34781985
doi: 10.1186/s12957-021-02435-8
pii: 10.1186/s12957-021-02435-8
pmc: PMC8591841
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
325Informations de copyright
© 2021. The Author(s).
Références
Womens Health (Lond). 2016 Sep;12(5):480-491
pubmed: 27885165
Am J Surg. 1998 Jul;176(1):8-11
pubmed: 9683123
Plast Reconstr Surg. 2016 Jul;138(1):240-252
pubmed: 27348657
Cureus. 2018 Apr 13;10(4):e2476
pubmed: 29904617
Arch Surg. 2002 Feb;137(2):137-42
pubmed: 11822946
Ann Plast Surg. 2017 Dec;79(6):536-540
pubmed: 28671886
PLoS One. 2015 Nov 06;10(11):e0142271
pubmed: 26544716
Int J Surg. 2013;11(6):496-500
pubmed: 23579255
Indian J Surg Oncol. 2014 Jun;5(2):95-8
pubmed: 25114459
J Otolaryngol Head Neck Surg. 2016 Nov 8;45(1):58
pubmed: 27821144
Breast Cancer (Auckl). 2019 Feb 19;13:1178223419829072
pubmed: 30814840
J BUON. 2008 Apr-Jun;13(2):223-30
pubmed: 18555469
J Laparoendosc Adv Surg Tech A. 2011 Jan-Feb;21(1):1-5
pubmed: 21166564
Gynecol Obstet Fertil. 2015 Jan;43(1):13-7
pubmed: 25483143
Ann Surg Oncol. 2017 Jul;24(7):1861-1867
pubmed: 28168385
Breast Cancer (Dove Med Press). 2016 Jul 18;8:125-40
pubmed: 27486342
J Breast Cancer. 2012 Dec;15(4):373-80
pubmed: 23346164
J Breast Cancer. 2011 Mar;14(1):58-63
pubmed: 21847396
World J Surg Oncol. 2004 Dec 09;2:44
pubmed: 15588301
Int J Surg. 2016 Jun;30:116-20
pubmed: 27142863
Gland Surg. 2014 Feb;3(1):22-7
pubmed: 25083490
Tuberc Respir Dis (Seoul). 2018 Apr;81(2):106-115
pubmed: 29372629
J Clin Oncol. 2003 Nov 15;21(22):4165-74
pubmed: 14559892
Clin Breast Cancer. 2012 Dec;12(6):454-8
pubmed: 23040644