Volume-controlled vs no/short-term drainage after axillary lymph node dissection in breast cancer surgery: A meta-analysis |
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| Authors: | R.A. Droeser D.M. Frey D. Oertli D. Kopelman M.J. Baas-Vrancken Peeters A.E. Giuliano K. Dalberg R. Kallam A. Nordmann |
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| Affiliation: | 1. Department of Surgery, Divisions of General Surgery and Surgical Research, University of Basel, Basel, Switzerland;2. Department of Surgery, “HaEmek” Medical Centre, Afula, and the Technion Israel Institute of Technology, Haifa, Israel;3. Department of Surgery, NKI-AvL Amsterdam, The Netherlands;4. John Wayne Cancer Institute Saint John''s Health Center, Santa Monica, CA, USA;5. Division of Surgery, Department of Clinical Science, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden;6. Combined Gastroenterology Unit, Scarborough General Hospital, Scarborough, UK;7. Basel Institute of Clinical Epidemiology, University of Basel, Basel, Switzerland;1. McLaren Flint, Flint, MI, USA;2. McLaren Macomb, Mt. Clemens, MI, USA;3. Regional Medical Imaging, Flint, MI, USA;4. Hurley Regional Medical Center, Flint, MI, USA;1. Gynecological Oncology, Fondazione del Piemonte per l’Oncologia (FPO), Candiolo Cancer Institute (IRCCS), Candiolo, Italy;2. University of Turin, Medical School, Turin, Italy;3. Radiation Therapy, Fondazione del Piemonte per l’Oncologia (FPO), Candiolo Cancer Institute (IRCCS), Candiolo, Italy;4. Department of Medical Sciences, University of Turin, Italy;5. Investigative Clinical Oncology, Fondazione del Piemonte per l’Oncologia (FPO), Candiolo Cancer Institute (IRCCS), Candiolo, Italy;6. Surgical Pathology, Fondazione del Piemonte per l’Oncologia (FPO), Candiolo Cancer Institute (IRCCS), Candiolo, Italy;1. University of South Florida Morsani College of Medicine, Tampa Florida;2. Comprehensive Breast Program, Moffitt Cancer Center, Tampa, Florida;3. Department of Surgery, University of South Florida, Tampa, Florida;4. Department of Biostatistics, Moffitt Cancer Center and Research Institute Tampa, Florida;1. College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China;2. Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China |
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| Abstract: | It is unknown whether there are any clinically relevant differences between volume-controlled (<30–50 ml/24 h across trials) vs no/short-term drainage after axillary lymph node dissection in breast cancer surgery on outcomes such as seroma formation, wound infection or length of hospital stay.Randomised controlled trials comparing volume-controlled drainage vs no or short-term drainage after axillary lymph node dissection in breast cancer surgery were identified systematically using Pubmed, EMBASE and The Cochrane library. Trial data were reviewed and extracted independently by two reviewers in a standardised unblinded manner.Six randomised controlled trials which included a total of 561 patients fulfilled our inclusion criteria. Patients randomised to volume-controlled drainage were less likely to develop clinically relevant seromas compared to patients randomised to no/short-term drainage. There was, however, no difference in wound infections between patients treated with volume-controlled drainage and patients with no or short-term drainage. Patients randomised to volume-controlled drainage stayed significantly longer in hospital than patients randomised to no/short-term drainage.Based on available evidence, clinically relevant seromas occur more frequently in patients treated with no/short-term drainage. However, no/short-term drainage after axillary lymph node dissection does not lead to an increase in wound infections and is associated with shorter hospital stay. |
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