Analysis of Perioperative Risk Factors for Complications Following Modified Radical Mastectomy- A Longitudinal Study
Introduction: Modern therapy for the breast cancer has evolved to include both surgical and systemic therapy. The Modified Radical Mastectomy (MRM) is the standard treatment option for most of the patients with breast cancer. Early complications are defined here as complications occurring within...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2021-07-01
|
| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2658/48340_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)_PB(AG_KM)_PN(KM).pdf |
| Summary: | Introduction: Modern therapy for the breast cancer has evolved
to include both surgical and systemic therapy. The Modified
Radical Mastectomy (MRM) is the standard treatment option
for most of the patients with breast cancer. Early complications
are defined here as complications occurring within 30 days
after surgery. The initial complications following MRM includes
wound infections, seromas, chronic pain, flap necrosis and
haematomas.
Aim: To study the frequency of occurrence of outcomes such as,
seroma, haematoma, flap necrosis, Surgical Site Infection (SSI)
following MRM and to associate the outcomes with the clinical,
demographic, intraoperative and postoperative factors.
Materials and Methods: The present study was a single centre
longitudinal cohort study with sample size of 72. Patients who
are admitted for MRM for carcinoma breast between January
2019 to January 2020 in Department of General Surgery, ESIC
MC & PGIMSR, Rajajinagar, Bengaluru, Karnataka, India, were
taken for study after considering the inclusion and exclusion
criteria. The data of risk factors collected were entered into a
proforma. After surgery they were observed postoperatively
for early complications. They were followed-up for a period
of one month. Information was entered in Statistical Package
for the Social Sciences (SPSS) software. Descriptive statistics
comprising of mean, average, standard deviation, proportion,
and percentage were used. Comparison of continuous data
was done by Student's t-test and categorical variables were
compared using Chi-square test. Variables with p-value <0.05
were considered as significant risk factor.
Results: Out of the 72 patients, who underwent MRM 27
(37.5%) developed seroma, 6 patients (8.3%) developed SSI
and 9 patients (12.5%) developed flap necrosis. There was
significant association between Seroma Formation (SF) and
higher age (p=0.026), higher BMI (p=0.001), hypertension
(p=0.004) and drain volume on day 1 (p<0.001). There was
significant association between SSI and Diabetes Mellitus
(DM) (p=0.002), prolonged duration of drain (p=0.03). There
was significant association between flap necrosis and DM
(p=0.003).
Conclusion: The incidence of seroma was higher in older,
hypertensive and in more obese patients. It was decreased
was decreased by flap fixation under muscles. The incidence
of SSI and flap necrosis was higher among diabetic patients.
Optimisation of glycaemia will help in reducing both. |
|---|---|
| ISSN: | 2277-8543 2455-6874 |