Comparison of Seroma Formation in Modified Radical Mastectomy: Conventional Scalpel Versus Ligasure™ Technique

Abstract

Objective: This study aims to compare the outcome of scalpel versus LigaSure™ dissection with respect to seroma formation in the skin flaps.
Methods: The study was conducted at the Department of General Surgery, Federal Government Polyclinic Hospital (FGPC), Islamabad. The study spanned over a period of twelve months, i.e. October 2020 to September 2021 which recruited 60 patients with breast cancer which were randomly assigned to two equal groups. Modified radical mastectomy with axillary lymph node dissection was done in all the patients. Group-I underwent traditional scalpel dissection while LigaSure™ dissection was done in the group- II. The primary outcome was to assess the seroma formation. The demographic data along with time required for surgery, duration of drain placement, and hospital stay was recorded. The recorded data was constructed and analyzed using SPSS (version 22.0).
Results: Among 60 enrolled patients, the mean age was 38.3 ± 11.4 and 39.8 ± 9.4 years in group I and II, respectively. A total of 6.7% (n=2) patients in group-I and 10% (n=3) patients in group-II showed seroma formation in skin flaps after surgery (p-value = 0.640). The mean time required for surgery was 109.9 ± 7.9 and 105.1 ± 8.3 minutes in group-I and group-II, respectively (p-value = 0.027). The average duration of hospital stay in group-I and group-II was 4.8 ± 1.7 and 5.3 ± 1.9 days (p-value=0.335).
Conclusion: Compared to traditional scalpel dissection, the use of LigaSure™ assisted dissection shows no significant benefit in terms of reduced post-operative seroma formation, and duration of hospital stay. However, LigaSure™ assisted dissection significantly reduces the time-of-surgery. In resourceful hospital settings, LigaSure™ assisted dissection can be used to reduce the morbidity associated with longer anesthesia time by reducing the time-of-surgery.