Studio prospettico randomizzato sulla rimozione precoce dei drenaggi nella chirurgia del cancro della mammella

Axillary seroma is absolutely the most frequent complication of breast cancer surgery. The Authors have accrued 100 consecutive breast cancer patients in a randomized study in order to compare seroma incidence by removingdrains on 2 n d postoperative day (1 s t arm) versus 3 r d postoperative day (2 n d arm); 48 patients were accrued in the first arm and 52 in the second. All patients received a standard axillary dissection. Two suction drains were placed. A compressive medication was applied after surgery. Patients started physiotherapy on the 1 s t postoperative day. The overall seroma prevalence was 21%. We have 8/48 (16%) seromas in the 1 s t group and 13/52 (25%) in the 2 n d . No significant differences were registered between two arms. Clinical seroma was treated by needle aspiration and medication with a steroid. Conclusions coming out from this study are: 1) early drains removal doesn't increase seroma rate; 2) axillary clearance has to be performed removing en bloc the fatty tissue respecting surgical plains; 3) apply a compressive bandaging; 4) early arm physiotherapy; 5) medication with steroid may reduce the fluid formation.