Relationship Between Numbers Of Drainage Tubes And Postoperative Subcutaneous Effusion In Patients After Mastectomy

Background:Subcutaneous effusion is the most common postoperative complication after mastectomy,it not only increases the incidence of skin flap necrosis,incision infection,lymphedema,etc,but also delays the time of postoperative radiotherapy.In order to reduce the formation of subcutaneous effusion,drainage tubes were regular placed postoperatively.However,no matter 1 drainage tube was placed or 2 drainage tubes were placed,subcutaneous effusion would appear in patients after the drainage tubes were pulled out,and the carrying of drainage tubes would bring inconvenience to patients’ life.Therefore,whether the number of drainage tubes can be reduced as far as possible without increasing the incidence of subcutaneous effusion is the main issue for analysis in this paper.In addition,in order to reduce the postoperative drainage volume and subcutaneous effusion,this paper discussed the relevant factors of the postoperative drainage volume and subcutaneous effusion respectively from the patient’s own factors,tumor characteristics and treatment methods,so as to find the method to reduce the postoperative drainage volume and subcutaneous effusion.Objective:Main purpose: To compare incidence of subcutaneous effusion in patients with 1drainage tube and 2 drainage tubes.Secondary purpose: To investigate the related factors affecting the drainage volume and subcutaneous effusion after mastectomy Methods and materials:A prospective 、 randomized 、 controlled trial of 282 patients who underwent mastectomy in Department of Breast Surgery,the First Hospital of Jilin University from September 10,2019 to January 7,2021.Patients were randomly divided into 1:1 groups,one group was implanted with one drainage tube postoperatively,the other group was implanted with two drainage tubes.The clinical and pathological data of all patients were collected and the postoperative drainage volume and subcutaneous effusion were followed up.SPSS26.0 software was used for statistical analysis to compare the incidence of postoperative subcutaneous effusion between the single-tube group and the double-tube group.The independent risk factors of drainage volume and subcutaneous effusion after operation were investigated.Results:Subcutaneous effusion occurred in 54(38.3%)of the 141 patients with 1 drainage tube and in 47(33.3%)of the 141 patients with 2 drainage tubes.Chi-square test was conducted to compare the occurrence of postoperative subcutaneous effusion between the two groups,P=0.385,and there was no statistical difference between the two groups.Logistic univariate regression model for analyzing the influencing factors of postoperative subcutaneous effusion showed that body mass index(BMI),diabetes,albumin<40g/L,prothrombin time(PT),drainage volume and left breast cancer were associated with the occurrence of subcutaneous effusion(P<0.05);Logistic multivariate regression analysis showed that albumin<40g/L was an independent risk factor for formation of postoperative subcutaneous effusion.Single factor linear regression model for analyzing the drainage volume after mastectomy showed that age、BMI、 triglyceride(TRIG),apolipoprotein B,cholinesterase,uric acid,activated partial thromboplastin time(APTT),prothrombin time(PT),prothrombin time ratio(PTR),international standardized ratio(INR),prothrombin time activity(PTA),number of lymph nodes removed,whether or not neoadjuvant,axillary lymph node dissection(ALND)and zinc(<10.7 and >17.7)were associated with postoperative drainage volume(P<0.05);Multifactor linear regression analysis showed that age,BMI and ALND were independent risk factors affecting drainage volume after mastectomy.Conclusion:(1)Only one drainage tube is need to be placed after mastectomy.(2)The occurrence of postoperative subcutaneous effusion is related to low albumin(<40g/L).(3)Factors affecting drainage volume after mastectomy were age,BMI and ALND.