Clinical Study On The Influence Of Modified Radical Mastectomy On Drainage Time Of Patients

Background:Breast cancer is one of the most common malignant tumors that seriously threatens women's physical and mental health.In recent years,the incidence of breast cancer in China has increased year by year,and the age of onset has become younger.At present,breast cancer ranks first in the incidence of female malignant tumors in China.With the development of breast surgery,the treatment of breast cancer has formed a multidisciplinary comprehensive treatment guided by the characteristics of tumor pathology and molecular biology,including surgical treatment,chemotherapy,radiotherapy,endocrine therapy,molecular targeted therapy and so on.Surgical treatment has always been an indispensable part of comprehensive treatment of breast cancer.The concept and method of surgical treatment of breast cancer have also undergone continuous evolution.The main trend is to continue to narrow the scope of resection injury on the premise of ensuring the therapeutic effect.Although breast conserving surgery has been promoted more and more in recent years,modified radical mastectomy for breast cancer is still one of the most commonly used operations for the treatment of breast cancer.However,this operation has disadvantages such as large surgical wound,large postoperative drainage volume and long postoperativecatheterization time.Several studies have shown that postoperative drainage volume and catheterization time are related to the prognosis of breast cancer.Objective:Retrospective analysis of influencing factors of postoperative catheterization time in patients with modified radical mastectomy Methods:The clinical and pathological data of 212 breast cancer patients admitted to the Department of Breast Surgery,China-Japan Union Hospital of Jilin University from November 2017 to July 2018 were retrospectively collected.Analysis of age,body mass index(BMI),tumor size(T),number of lymph node metastases(N),axillary drainage 48 hours after surgery,chest drainage 48 hours after surgery,hypertension,diabetes,preoperative neoadjuvant chemotherapy,Perioperative oral rivaroxaban antithrombotic treatment,preoperative serum albumin level,preoperative serum prealbumin level,energy surgical instruments,intraoperative loboplatin flushing of the wound cavity,indwelling drainage tube for patients with modified radical mastectomy of breast cancer The impact of time(chest,underarm).Univariate analysis uses t test and variance test,correlation uses Pearson correlation analysis,and multivariate analysis uses binary logistic regression analysis.Result:1.Univariate analysis results showed: age,body mass index(BMI),diabetes,hypertension,energy surgical instruments,number of lymph node metastases(N),intraoperative loboplatin flushing of the cavity,perioperative oral rivaroxaban antithrombotic Treatment,48-hour postoperative axillary drainage,and preoperative serum albumin levels had statistically significant differences in the time of postoperative axillary catheterization in patients with modified breast cancer(t =-2.235,t =-3.196,t =-5.427,t =-3.218,t =2.540,F = 1.878,t =-2.850,t =-4.758,t =-3.303,t =-2.365;all P <0.050).Binary Logistic regression analysis showed: the number of lymph node metastases(N),oral rivaroxaban antithrombotic therapy during the perioperative period,48-hour postoperative axillary drainage,and the time for postoperative axillary catheterization in patients with modified radical mastectomy for breast cancer The obvious correlation is an independent influencing factor(OR = 1.447,2.625,2.219,3.269;all P <0.050).2.Single factor analysis showed: age,body mass index(BMI),diabetes,hypertension,energy surgical equipment,perioperative oral rivaroxaban antithrombotic therapy,48 hours postoperative chest drainage,preoperative serum albumin The level was statistically significant for the difference in the time of the chest tube after the modified radical mastectomy(t =-2.852,t =-3.226,t =-3.681,t =-2.909,t =-2.732,t =-2.075,t =-4.132,t =-2.226;all P <0.050).Binary Logistic regression analysis showed that: 48 hours postoperative chest drainage,energy surgical equipment and breast cancer patients undergoing radical mastectomy have a significant correlation,whichis an independent influencing factor(OR = 2.636,4.914;all P <0.050).3.Pearson correlation analysis showed that there was a correlation between the chest flow after the radical breast cancer surgery and the48-hour drainage after armpit surgery(r = 0.176;p = 0.01);It was correlated with the time of axillary tube insertion(r = 0.415;p <0.001).Conclusion:1.(1)Age,body mass index(BMI),diabetes,hypertension,energy surgical instruments,number of lymph node metastases(N),intraoperative loboplatin flushing of the wound cavity,oral rivaroxaban antithrombotic therapy during the perioperative period,surgery Axillary drainage volume and serum albumin level before 48 hours are the influencing factors of the time of axillary catheterization in patients with modified breast cancer.(2)Preoperative serum prealbumin levels,tumor size(T),and pre-adjuvant neoadjuvant chemotherapy had no significant effect on the time of axillary catheterization in patients with modified breast cancer after radical surgery.(3)The number of lymph node metastases(N),oral rivaroxaban antithrombotic therapy during the perioperative period,48-hour postoperative axillary drainage,and diabetes are independent factors that affect the time of axillary catheterization in patients with modified breast cancer.2.(1)Age,body mass index(BMI),diabetes,hypertension,energy surgery equipment,perioperative oral rivaroxaban antithrombotic therapy,48 hours postoperative chest drainage,preoperative serum albumin level It is the influencing factor of the chest tube preoperative time after the modified radical mastectomy for breast cancer.(2)Number of lymph node metastases(N),intraoperative loboplatin flushing of the wound cavity,preoperative serum prealbumin level,tumor size(T),preoperative neoadjuvant chemotherapy for breast cancer after radical mastectomy No obvious impact.(3)48 hours postoperative chest drainage and energy surgical instruments are independent factors that affect the time of chest precanalization after modified radical mastectomy for breast cancer.3.(1)There is a correlation between the drainage of the breast and the armpit 48 hours after the modified radical mastectomy.(2)There is a correlation between the time of chest tube and armpit tube placement after modified radical mastectomy.