The Formation And Prevention Of Seroma Following Surgery For Breast Cancer

Object:To investigate the source of the drainage and the seroma following surgery for breast cancer and the high-risk factors for seroma;to find a effective way to shorten the time for drainage and decrease the incidence of seroma.Method:Retrospective study and random perspective study are both used in this study.We reviewed the data from 3/2003 to 6/2006(control group,n=84).The patients in 6/2006 to 2/2009(n=111) were taken into three groups randomly,the axillary lymphatic from upper extremity of ligature group patients were ligated by ligature(n=91);the axillary lymph node dissection in the patients of ultracision group were done by ultracision(n=7); the patients in new J-P group were suction drained by the new J-P suction drainage system(n=13).Analyze the correlation between the risk factors and the time for drainage, the volume of drainage,seroma and other complications.We confirmed that seroma ascribes the lymphorrhea by lymphoscintigraphy.Result:Tc-99 was concentration in the axilla where the drainage accumulative,it means that lymphorrhea is one of the reason for seroma;the average days for drainage is 16±15 day,and the incidence of seroma is 4.1%.The time for drainage in the group whose lymphatic in the axilla were ligatured is distinguished shorter than which in the control group(14.22±12.17days VS 19.48±18.41days,p＜0.05);and the incidence of seroma is the same(1/91 VS 7/84,p＜0.05);the volume of draining for 72h after modified radical operation is extraordinarily more than which after conservative breast surgery(257.33±134.63ml VS 190.95±110.62ml,p＜0.05),and the time for drainage (16.07±14.19days VS 17.02±18.04days,p＞0.05) and the incidence of seroma(4/139 VS 4/56,p＞0.05) are no difference;the time for drainage of the patients who did adjuvant chemotherapy is distinguished longer than the time for the patients who didn't do adjuvant chemotherapy(17.35±16.12days VS 10.11±6.49days,p＜0.05),the incidence of the seroma is no difference(0/17 VS 8/168,p＞0.05).Conclusion:Lymphorrhea is the lnean source of the drain fluid and the seroma following surgery for breast cancer,although extravasate is the mean composition in the first 72h after the surgery;ligatured the lymphatic in the axilla can shorten the time for drainage and decrease the incidence of seroma effectually,chemotherapy is one of the risk factor for needing more drainage and an increased incidence of seroma.