Lymphatic Ligation versus Conventional Axillary Lymph Node Dissection in Breast Cancer Patients: A Randomized Control Trial
Keywords:
Breast cancer, axillary dissection, seroma, lymphatic ligationAbstract
Background and Objective: Seroma was a common complication of breast cancer surgery. It is a source of significant morbidity that led to delay adjuvant treatment. The primary objective was to evaluate seroma formation in a comparison between the lymphatic ligation technique and conventional axillary lymph node dissection.The secondary objective was to evaluate the factors affecting seroma formation.
Materials and Methods: A randomized control trial was conducted between January 2014 and November 2017.Sixty eight consecutive patients underwent mastectomy with axillary lymph node dissection by one experiencedsurgeon. The patients were randomly assigned to Group1 (lymphatic ligation) (n=34) and Group 2 (conventional surgery) (n=35).
Results: 18 patients developed seroma (26.09%) with 8 (23.53%) patients were in the lymphatic ligation group and 10(28.57%) patients were in the conventional group. No statistical significance was found in seroma formation (p = 0.633), drain duration (p =0.238) or total drain volume (p = 0.330) between the two groups. Lymphatic ligation was statistically and significantly correlated with longer operative time (p = 0.002). Age, BMI, total drain volume and drain dislodgement were significant factors influencing seroma formation (p = 0.005, p = 0.002, p = 0.008, p = 0.015, respectively). Multivariate analysis showed age and BMI were significant factors influencing seroma formation (p = 0.008, p = 0.025, respectively).
Conclusion: The lymphatic ligation technique could not reduce the incidence of seroma formation. Age, BMI were the factors influencing seroma formation in the patients undergoing mastectomy with axillary lymph node dissection.
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