NEW YORK (Reuters Health) – An electrothermal bipolar vessel sealing system (LigaSure Precise, Valleylab) reduces operative time and appears to be effective in women undergoing modified radical mastectomy with axillary dissection, according to Greek researchers.
"Even though modern day surgical management of breast cancer continues to focus appropriately on breast-conserving techniques," Dr. Haridimos Markogiannakis told Reuters Health, "modified radical mastectomy with axillary lymph node dissection remains the most frequently performed surgical procedure for locally advanced breast cancer."
In the June issue of the Archives of Surgery, Dr. Markogiannakis and colleagues at the University of Athens note that the approach may engender a variety of complications, including those involving lymph vessel sealing and hemostasis.
To see what advantages the electrothermal sealing system might have in this regard, the researchers prospectively studied 60 patients who underwent the same procedure performed by the same surgical team.
Intraoperative blood loss ranged from 25 to 70 mL compared to 55 to 332 mL in historical controls. Corresponding ranges for operative time were 80 to 125 minutes and 117 to 210 minutes. For mean mastectomy drainage volume, the figures were 5 to 40 mL versus 213 to 320 mL.
In addition, hospital stay was from 3 to 6 days, compared to 2.4 to 10.1 days in controls. There were no postoperative complications in the study group.
"Our results," continued Dr. Markogiannakis, "showed that the technique is feasible, safe and effective. The main advantage of the device is that it simplifies the procedure while achieving efficient lymph vessel sealing and hemostasis. This technique seems to result in reduced perioperative blood loss, operative time, drainage volume and duration, and postoperative complications incidence such as seroma or lymphedema."
"Further studies," he concluded, "are necessary to evaluate the results of utilization of the device and its impact on perioperative complications."
Arch Surg 2008;143:575-580.