Abdominal wall pseudocyst following abdominoplasty after postmastectomy radiation therapy

Abdominoplasty is a common surgical procedure that is performed either alone or in conjunction with other intra abdominal procedures. Seroma is a known occurrence after abdominoplasty and various techniques have been described to reduce the quantity and duration of seroma formation. We report a case of pseudocyst following abdominoplasty after post mastectomy radiation. Breast reconstruction with abdominal flaps after abdominoplasty, and the effect of radiation in immediate and delayed flap reconstruction have been described but we could not find any literature on abdominoplasty following radiotherapy. The pathogenesis of seroma formation and, as in our case, the effect of radiation, which is the likely cause of pseudocyst, is discussed.     

手术治疗乳腺癌术后顽固性血清肿（附13例报告）

目的探讨手术治疗乳腺癌术后并发顽固性血清肿的治疗价值。方法回顾性分析1998年1月至2008年9月本科收治28例乳腺癌术后并发顽固性血清肿的临床资料，其中手术治疗组13例，常规治疗组15例。观察两种治疗方法的拔管时间、日均引流量和总引流量；拔管时间采用两样本比较秩和检验、日均引流量和总引流量采用两样本独立t检验。结果手术治疗组拔管时间为41．07±2．59d，常规治疗组拔管时间为59．13±11．04d，差异有统计学意义（T=91．5，P〈0．05）。手术治疗组日平均引流量为39．84±4．21ml，常规治疗组日平均引流量则为37．86±2．58ml，差异无统计学意义（t=1．52，P〉0．05）。手术治疗组总引流量为1635．61±186．70ml，常规治疗组则为2232．05±410．05ml，差异有统计学意义（t=-5．06，P〈0．05）。结论手术治疗乳腺癌术后顽固性血清肿具有明显缩短拔管时问，减少体液丧失的优点：     

Effectiveness of fibrin glue in conjunction with collagen patches to reduce seroma formation after axillary lymphadenectomy for breast cancer

BACKGROUND: Axillary lymphadenectomy remains an integral part of breast cancer treatment, yet seroma formation occurs in 15% to 85% of cases. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies, with controversial results. METHODS: Fifty patients underwent quadrantectomy or mastectomy with level I/II axillary lymphadenectomy; a suction drain was fitted in all patients. Fibrin glue spray and a collagen patch were applied to the axillary fossa in 25 patients; the other 25 patients were treated conventionally. RESULTS: Suction drainage was removed between postoperative days 3 and 4. Seroma magnitude and duration were significantly reduced (P = .004 and .02, respectively) and there were fewer evacuative punctures in patients receiving fibrin glue and collagen patches compared with the conventional treatment group. CONCLUSIONS: Use of fibrin glue with collagen patches does not always prevent seroma formation, but it does reduce seroma magnitude and duration, as well as necessary evacuative punctures.     

Seroma treatment after dermo-lipectomy

We can consider the seroma as a rather common complication in abdominal dermo-lipectomy surgery. In our case, the possibility has arisen to successfully reduce a remarkable accumulation of liquid using a simple but efficient protocol consisting on cortisone infiltrations.     

Chronic posterior seroma with neoperitoneum following laparoscopic ventral hernia repair: treatment algorithm

Laparoscopic ventral hernia repair (LVHR) is now widely performed. One of the most common complications of this procedure is seroma. Most seromas usually form anterior to the mesh and resolve with conservative management. In rare cases, some patients develop a pseudoneoperitoneum deep to the mesh which actively secretes fluid, forming a collection. We present a group of seven patients with persistent seroma posterior to the mesh and a possible treatment algorithm.     

Functional impairment and complaints following incisional hernia repair with different polypropylene meshes

The influence of mesh material on the clinical outcome of hernia repair has often been neglected, although recent studies have clearly demonstrated the importance of mesh properties for integration in the abdominal wall. Of particular significance are the amount of mesh material and the pore size. In the following study, patients received different mesh types with distinct amounts of polypropylene and of various pore sizes for incisional hernia repair. We investigated whether the type of material influenced the clinical and functional outcomes. Between 1991 and 1999, 235 patients received polypropylene meshes in a sublay position for incisional hernia repair: 115 patients were implanted with a Marlex heavy-weight mesh (Mhw mesh), 37 patients with an Atrium heavy-weight mesh (Ahw mesh) and 83 with a Vypro low-weight mesh (Vlw mesh). The study protocol included ultrasound examination and 3D-stereography in all patients, with a total follow-up of 24±13 months (Mhw-mesh), 11±8 months (Ahw-mesh) and 8±7 months (Vlw-mesh). Our findings demonstrate that the side effects of mesh implantation, comprising paraesthesia and restriction of abdominal wall mobility, were significantly affected by the type of material implanted. Three-dimensional stereographic examinations were well in accordance with our clinical findings. Our data support the hypothesis that the use of low-weight large-pore meshes is advantageous for abdominal wall function. Electronic Publication     

乳腺癌术后血清肿形成的相关危险因素分析

目的：探讨乳腺癌术后血清肿形成的相关危险因素。方法：对276例女性乳腺癌手术患者进行回顾性分析。对可能与血清肿形成有关的年龄、肿瘤大小、腋窝淋巴结转移、手术方式、手术器械、术前辅助化疗、弹力绷带的应用、腋窝引流时间等8项危险因素进行卡方检验及多因素Logistic回归分析。结果：276例患者行保乳术56例,根治术22例,改良根治术198例。术后并发血清肿98例（35.5%）;根治术和改良根治术同血清肿的高发生率具有显著相关性,OR值分别为2.83和3.97,P〈0.05。其他研究因素与乳腺癌术后血清肿的高发率无明显相关性。结论：手术方式是乳腺癌术后血清肿形成的危险因素,同保乳术比较,根治术和改良根治术增加了乳癌术后血清肿形成的危险性。