Tumescent technique versus electrocautery mastectomy: A randomized controlled trial

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Breast cancer is a prevalent malignancy among Danish women, with mastectomy being a common surgical intervention.
• In 2016, approximately 31% of Danish breast cancer patients underwent mastectomy.
• Comparing surgical techniques is crucial for optimizing patient outcomes and minimizing complications.

Purpose of the Study:

• To compare the frequency of postoperative complications between electrocautery dissection and tumescent technique during mastectomy.
• To evaluate the safety and efficacy of two distinct surgical approaches for mastectomy.

Main Methods:

• An open randomized controlled trial was conducted involving female patients undergoing primary breast cancer or DCIS mastectomy.
• The study included patients from January 2012 to October 2017, comparing tumescent technique with electrocautery dissection.
• Primary outcomes assessed included seroma, bleeding, infection, and necrosis, with secondary outcomes focusing on surgery duration and treatment delays.

Main Results:

• The study included 357 patients (371 breasts). No significant differences were observed in seroma production, bleeding, infection, or necrosis between the tumescent and electrocautery groups.
• Infection rates were low (5.9% vs. 7.5%) and not statistically different between the techniques.
• Surgical duration and the delay of adjuvant treatment due to complications did not significantly differ between the two groups.

Conclusions:

• Both electrocautery dissection and tumescent technique demonstrate comparable safety profiles for simple and modified radical mastectomy.
• The findings suggest that either technique can be safely employed in mastectomy procedures without a significant increase in postoperative complications.