Harmonic scalpel versus electrocautery in axillary lymph-node dissection in patients with breast cancer: a prospective randomized study

Moussa, Hossam Ramadan; Elmahdy, Tamer M.; Abdelhamid, Amir Fawzy

doi:10.4103/ejs.ejs_185_21

Harmonic scalpel versus electrocautery in axillary lymph-node dissection in patients with breast cancer: a prospective randomized study

Authors

Abstract

Background
Multiple techniques have been used for tissue dissection and achieving hemostasis during breast surgery, including harmonic scalpel and electrocautery. However, there are some conflicting results between different studies regarding some parameters like operative time and seroma formation. This study aims to compare between the previous two techniques for axillary lymph-node dissection in breast cancer patients.
Patients and methods
We recruited 98 cases diagnosed with breast cancer for this prospective randomized study. The cases were divided into two groups according to the dissection technique, harmonic, and electrocautery groups. Intraoperative and postoperative parameters were compared between the two groups.
Results
Both patient and tumor criteria were comparable between the two groups. However, both operative time and blood loss showed a significant decrease with harmonic use. In addition, the same device led to a significant decrease in drain discharge and early drain removal. However, no significant difference was noted regarding the number of dissected lymph nodes and the duration of hospitalization. As regards postoperative complications, it showed no significant differences between the study groups.
Conclusion
Harmonic scalpel is more beneficial compared with the conventional electrocautery technique. It is associated with shorter operative time, less blood loss, less postoperative pain, less drainage discharge, and early drain removal.

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