Clinical Value Of Dexamethasone Intervention On Seroma Formation After Modified Radical Mastectomy For Breast Cancer

Objective To investigate the effect of intraoperative dexamethasone intervention on drainage tube indentation time and subcutaneous seroma volume after modified radical mastectomy for breast cancer,and to provide a new choice for the prevention and treatment of postoperative seroma.Methods Patients diagnosed with breast cancer in the Department of General Surgery of Ordos Central Hospital from January,2020,to December,2021,were collected according to the criteria of natron.Two drainage tubes were indwelled intraoperatively as 18F(cylindrical)negative pressure drainage tubes.A total of 31 patients were treated with dexamethasone as an experimental group.Patients diagnosed with breast cancer in The General Surgery Department of Ordos Central Hospital from January,2017 to January,2020.All patients underwent modified radical mastectomy(Auchincloss-Madden method).Two drainage tubes were indwelled intraoperatively as 18F(cylindrical)negative pressure drainage tubes.There were 34 cases without dexamethasone as a control group.Perioperative characteristic data and data of the two groups were collected for statistical analysis.Results According to the inclusion and exclusion criteria,65 patients were eventually included in this study,which were divided into the dexamethasone group(experimental group n=31)and the non-dexamethasone group(control group n=34)according to whether the intraoperative medication was used.The enrolled patients ranged in age from 37 to 82 years and were divided into young and middle-aged groups<60 years old(n=48)and older groups≥60 years old(n=17).According to BMI,the patients with<24 kg/m~2non-overrecombinant(n=27)and≥24 kg/m~2overrecombinant(n=38);6 patients had diabetes history;12 patients had a history of hypertension;Left surgery was performed on 34 patients and right surgery was performed in 31 patients.1.The control group(n=34)and experimental group(n=31)in two groups of patients’age,BMI,the mass position(left/right),history of diabetes,hypertension history,preoperative albumin,white blood cells,prothrombin time,partial activation of prothrombin time,the ratio of international standardization,the C-reactive protein(CRP)there was no statistically significant difference(P>0.05).Data distribution is balanced and comparable.2.Group by the median indwelling time of drainage tube(18 days),Single-factor analysis results show two groups of patients in age,BMI,the mass position(left/right),history of diabetes,hypertension history,preoperative albumin,white blood cells,prothrombin time,partial activation of prothrombin time,ratio of international standardization,the C-reactive protein(CRP)and subcutaneous seroma volume 7 days before the difference has no statistical significance(P>0.05).3.The median postoperative subcutaneous seroma(84 ml)was divided into two groups.Univariate analysis showed that there were statistically significant differences in postoperative subcutaneous seroma between the two groups in terms of left/right side and history of diabetes(P<0.05).There was no significant difference in age,BMI,history of hypertension,preoperative albumin,white blood cell,prothrombin time,partially activated prothrombin time,international standardized ratio,and C-reactive protein(CRP)(P>0.05).4.The subcutaneous seroma volume was grouped as dependent variables,and the indicators with statistical significance in the above univariate analysis were left/right and diabetes history as independent variables for binary Logistic regression analysis.The results showed that left/right and right operation(OR=0.343,95%CI=0.121-0.977)were independent risk factors affecting postoperative subcutaneous seroma volume(P<0.05).Since the history of diabetes in the contingency table is 0,it needs to be corrected and is an independent risk factor affecting the postoperative subcutaneous seroma volume.5.The independent risk factors in the multivariate analysis,left/right and history of diabetes as variables,were analyzed in the dexamethasone group and the traditional group respectively.Drainage tube indentation time and subcutaneous seroma volume were compared between the dexamethasone group and the non-dexamethasone group,and there was no statistical difference between the two groups(P>0.05).6.Patients were divided into groups according to the left and right sides of the tumor position,and the drainage tube indwelling time and subcutaneous seroma volume in the two groups were compared respectively.No statistical difference was found(P>0.05).7.The patients were divided into two groups according to whether they had a history of diabetes or not,and the drainage tube indentation time and subcutaneous seroma volume were compared in the two groups.No statistical difference was found in the results(P>0.05),and the occurrence of a value of 0 in the contingency table needs to be corrected or the sample size is too small to be counted.Conclusions 1.For patients undergoing modified radical mastectomy for breast cancer,intraoperative use of dexamethasone has no significant effect on the indentation time of the drainage tube and postoperative subcutaneous seroma formation.2.The related factors affecting seroma flow after modified radical mastectomy were diabetes history and right surgery.