Hydrodissection technique versus electrocautery technique in nipple-sparing mastectomy: a comparative study

Asal, Mohamed F.; Barakat, Khaled E.; Korayem, Islam M.; Fayed, Haytham; Abdelkader, Ahmed A.

doi:10.4103/ejs.ejs_22_23

Hydrodissection technique versus electrocautery technique in nipple-sparing mastectomy: a comparative study

Authors

Abstract

Background
Approximately 26% of all cancers in women are breast cancers, making it the most prevalent cancer among women. Breast cancer is the second leading cause of cancer-related mortality, behind lung cancer, with 40 000 women dying from it each year. Tumescent dissection or hydrodissection (HD) is a technique that uses a crystalloid solution together with a local anesthetic and epinephrine to produce a subcutaneous and prepectoral plane throughout mastectomy. This research compared this approach with electrocautery mastectomy to assess postoperative complications and surgical results.
Patients and methods
The study involved 60 female breast cancer patients, who were hospitalized to the Surgical Oncology Unit at Alexandria Main University Hospital and who were advised to have a nipple-sparing mastectomy (NSM) between June 2020 and June 2022. Randomization was used to assign patients to group A or group B. Group A patients underwent NSM using the tumescent technique and group B patients had standard electrocautery-assisted mastectomies.
Results
Sixty NSM procedures were performed (30 patients in the HD group and 30 in the electrocautery group). The demographics of the patients in both groups were fairly the same. HD required less time during surgery than a normal mastectomy. We also discovered that the tumescent group experienced significantly less intraoperative bleeding than the electrocautery group. In terms of the average amount of fluid that exits the drain each day, we discovered that there was a much lower amount of fluid in the tumescent group compared with the electrocautery group. The overall rate of complications was 25%; in the tumescent group, there were seven (23.3%) complications and in the electrocautery group, there were eight (26.67%) complications.
Conclusions
The tumescent technique may give a safe alternative to the electrocautery technique, allowing for simpler tissue dissection without direct heat harm. It considerably reduces the operating time and the time required for skin flap lifting, as well as the quantity of intraoperative hemorrhage and seroma in the drain postoperatively, resulting in early drain removal.

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