Breast cancer patients after axillary lymph node dissection with LigaSure and conventional method and structure of the effect of seroma: Prospective randomized clinical trial

In various fields of surgery, a newly developed thermal energy systems for the purpose of hemostasis and dissection (LigaSure, argon plasma coagulator, Cavitron Ultrasonic Surgical Aspirator, Ultracision, etc.) are used. ForceTriad LigaSure system (Valleylab Boulder, Colorado) recently introduced as a primary provider of hemostasis is a device developed for abdominal surgery. Ligasure, which is up to 7 mm diameter vessels denatured collagen and elastin fibers whether gag creating provides hemostasis. (8) The aim of this randomized clinical study, and axillary lymph node dissection for breast cancer patients who underwent surgery, vessel sealing device (LigaSure), the amount of postoperative fluid from draining, draining the liquid from the change in structure, length of stay and the resistance was to investigate the effect of seroma formation. Radiological and histological study with a diagnosis of breast cancer patients undergoing modified radical mastectomy were included operesyonu. All of these patients underwent level II axillary lymph node dissection. with a positive sentinel lymph node biopsy and axillary lymph node dissection for clinically positive axillary lymph node with mean age 56.60 ± 12.6 A total of 21 patients were included. Patients were divided into two groups. Electrocautery and connect to the first group, the second group was axillary lymph node dissection with LigaSure. Group I (n = 11), mean age 61.45 ± 13.56 years, Group II (n = 10), mean age 51.30 ± 9.57 years. Between the two groups menopausal status, body mass index, the patient's height, weight, number of metastatic lymph nodes, number of lymph nodes removed, the removed tissue weight, tumor size, lymph node statistically significant difference was found in terms of number. The use of LigaSure shortened operation time. However, seroma formation, drainage ligasure in terms of duration and amount of drainage method with the use of electrocautery were no differences in binding. In drainage of fluids from the days of complete blood count and biochemical changes in the groups was not found statistically significant differences between them In comparing the days were no statistically significant changes over time in the groups of their own. Seroma formation, although the pathophysiology remains unclear, especially as a result of the lymphatic drainage system, interfere with axillary lymph node dissection suffer a major consensus is that the most important reasons. Seroma formation obesity, age, hypertension, defined in the etiology of many factors such as surgical technique and the use of electrocautery. Seroma alone, although not life-threatening complication caused by infection and necrosis, causes an increase in morbidity. Seroma extends the duration of hospital stay, increased incidence of post-discharge control the patient's wound, and even leads to a delay of adjuvant therapy. Modified radical mastectomy surgery complications due to bleeding, infection, necrosis, and seroma may be considered. The most common complication is seroma. Alone increases the risk of infection and necrosis, seroma formation, adhesion and length of hospital stay, duration of chest wall flaps extended. Modified radical mastectomy is the most common complication of surgery, and 8.4% seroma accumulation - of 85% seen. Seroma serous fluid under the skin flaps after mastectomy and axillary dissection or axillary accumulation of dead space. Factors increasing the formation of seroma; -Excessive excess dead space created after dissection, -Chest wall irregularity, -Age, -Body-mass index in excess, -Systemic diseases (eg, diabetes), -Respiratory movements of the chest wall mobility, -Shoulder and arm movements can be listed as pumping lymph flow (13). Proposed a number of measures to reduce the incidence of seroma complication. These sclerotherapy, sewing chest wall flaps, shoulder and arm movement restrictions, the early withdrawal of drains can be listed as (8,9). However, the most effective method is the use of closed absorbent drainage systems. With the cutting process of hemostasis and tissue as a result of the operation of the device can be used LigaSure ForceTriad, be safe and effective, but no significant difference in the formation of seroma, were found to be safe in terms of the development of postoperative complications. Seen as an alternative to the conventional technique in this respect