Background: Electrocautery has been shown to be associated with excessive serous drainage which may lead to
many complications in patients with breast cancer needing dissection of the axillary lymph nodes. The Harmonic
Focus could outperform electrocautery in dissection of axillary lymph nodes, resulting in shortening of the
operative times and minimize postoperative complications. This study aims to compare the mean axillary drain
production and the axillary numbness frequency in axillary lymph node dissection (ANLD) during Modified
Radical Mastectomy (MRM) and breast conservative surgery (BCS) between the use of harmonics scalpel and
electrocautery.
Methods: This study includes 40 patients presented with early breast cancer (T1 and T2) underwent BCS or MRM
in general surgery department, Faculty of Medicine, Benha University Hospital during the period from January
2017 to September 2019. The patients randomly assigned into 2 groups; group A: subjected to ANLD using
Harmonic Focus tool and group B: subjected to ANLD using electrocautery. Operative time, total drainage volume,
blood loss, duration of the drain and frequency of axillary numbness were recorded.
Results: This study shows that using Harmonic in axillary dissection considerably reduced operating time, total
drainage volume, blood loss, days of hospital stays and reduced axillary numbness level in comparison to conventional
electrocautery.
Conclusion: Compared to the normal electrocautery, the harmonic focus dissection has major advantages in
lowering postoperative drainage, blood loss intra-operative and lower incidence of axillary numbness in breast
cancer axillary dissection, without affecting operating time. |
