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Modified Radical Mastectomy With Axillary Dissection Using the Electrothermal Bipolar Vessel Sealing System
Andreas Manouras, MD, PhD;
Haridimos Markogiannakis, MD;
Michael Genetzakis, MD;
George M. Filippakis, MD, PhD;
Emmanuel E. Lagoudianakis, MD;
Georgia Kafiri, MD, PhD;
Konstantinos Filis, MD, PhD;
George C. Zografos, MD, PhD
Arch Surg. 2008;143(6):575-580.
Hypothesis The use of the electrothermal bipolar vessel sealing system is feasible, safe, and effective in modified radical mastectomy with axillary dissection in terms of lymph vessel sealing, hemostasis, and perioperative complications.
Design Prospective study.
Setting University surgical department.
Patients Between January 1, 2003, and December 31, 2003, 60 patients with locally advanced breast cancer (T2 or T3) admitted for modified radical mastectomy with axillary dissection were included in this study. The entire procedure was performed by the same surgical team using the electrothermal bipolar vessel sealing system.
Main Outcome Measures Final outcome, operative time, hospitalization stay duration, intraoperative blood loss, postoperative mastectomy and axillary drainage volume and duration, and postoperative complications (seroma, bleeding, skin burn, hematoma, lymphedema, pneumothorax, and wound infection or necrosis).
Results The mean (SD) intraoperative blood loss was 45 (12) mL, and the mean (SD) operative time was 105 (7) minutes. No postoperative bleeding, seroma, hematoma, lymphedema, or other complications occurred. The mean (SD) mastectomy and axillary drainage volumes were 20 (8) and 155 (35) mL, respectively, and the mean (SD) drainage durations were 1.3 (0.2) and 2.7 (0.5) days, respectively. The mean (SD) hospital stay was 3.7 (0.6) days.
Conclusions In this first report (to our knowledge) of modified radical mastectomy with axillary dissection using the electrothermal bipolar vessel sealing system, the technique was feasible, safe, and effective. The device simplified the surgical procedure, while achieving efficient lymph vessel sealing and hemostasis. Compared with historical data regarding the conventional or harmonic scalpel, this technique seems to result in reduced operative time, perioperative blood loss, drainage volume and duration, and incidence of seroma or lymphedema. Prospective randomized controlled studies are necessary to evaluate the effect of this technique on perioperative complications.
Author Affiliations: First Department of Propaedeutic Surgery (Drs Manouras, Markogiannakis, Genetzakis, Filippakis, Lagoudianakis, Filis, and Zografos) and Department of Histopathology (Dr Kafiri), Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece.
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Modified Radical Mastectomy With Axillary Dissection Using the Electrothermal Bipolar Vessel Sealing System—Invited Critique
David Euhus
Arch Surg. 2008;143(6):581.
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