Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2024

Open Access 01-12-2024 | Breast Cancer | Research

Comparison of the effect of ultrasounic-harmonic scalpel and electrocautery in the treatment of axillary lymph nodes during radical surgery for breast cancer

Authors: Yujia Tian, Lifei Han, Xiao Ma, Rui Guo, Zhuoga GeSang, Yabo Zhai, Haolin Hu

Published in: World Journal of Surgical Oncology | Issue 1/2024

Login to get access

Abstract

Objective

To compare the efficacy of ultrasounic-harmonic scalpel and electrocautery in the treatment of axillary lymph nodes during radical surgery for breast cancer.

Methods

A prospective study was conducted in the Department of Breast Surgery, Zhongda Hospital Affiliated to Southeast University. A total of 128 patients with pathologically confirmed breast cancer who were treated by the same surgeon from July 2023 to November 2023 were included in the analysis. All breast operations were performed using electrocautery, and surgical instruments for axillary lymph nodes were divided into ultrasounic-harmonic scalpel group and electrocautery group using a random number table. According to the extent of lymph node surgery, it was divided into four groups: sentinel lymph node biopsy, lymph node at station I, lymph node at station I and II, and lymph node dissection at station I, II and III. Under the premise of controlling variables such as BMI, age and neoadjuvant chemotherapy, the effects of ultrasounic-harmonic scalpel and electrocautery in axillary surgery were compared.

Results

Compared with the electrosurgical group, there were no significant differences in lymph node operation time, intraoperative blood loss, postoperative axillary drainage volume, axillary drainage tube indwelling time, postoperative pain score on the day after surgery, and the incidence of postoperative complications (p>0.05).

Conclusion

There is no significant difference between ultrasounic-harmonic scalpel and electrocautery in axillary lymph node treatment for breast cancer patients, which can provide a basis for the selection of surgical energy instruments.
Literature
3.
go back to reference Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: an overview [published online ahead of print, 2021 Apr 5]. Int J Cancer. 2021:10. Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: an overview [published online ahead of print, 2021 Apr 5]. Int J Cancer. 2021:10.
4.
go back to reference Mansel RE, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98(9):599–609.CrossRefPubMed Mansel RE, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98(9):599–609.CrossRefPubMed
5.
go back to reference Giuliano AE, McCall L, Beitsch P, et al. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg. 2010;252(3):426–32.CrossRefPubMed Giuliano AE, McCall L, Beitsch P, et al. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg. 2010;252(3):426–32.CrossRefPubMed
6.
go back to reference Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75.CrossRefPubMedPubMedCentral Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75.CrossRefPubMedPubMedCentral
7.
go back to reference Galimberti V, Cole BF, Zurrida S, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14(4):297–305.CrossRefPubMedPubMedCentral Galimberti V, Cole BF, Zurrida S, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14(4):297–305.CrossRefPubMedPubMedCentral
8.
go back to reference Donker M, van TG, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15(12):1303–10. Donker M, van TG, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15(12):1303–10.
10.
go back to reference Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl. 1986;3:S1–226. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl. 1986;3:S1–226.
11.
go back to reference Sato Y,Gosho M,Nagashima K,et al. Statistical methods in the journal-an update[J]. N Engl J Med.,2017,376(11):1086-1087.CrossRefPubMed Sato Y,Gosho M,Nagashima K,et al. Statistical methods in the journal-an update[J]. N Engl J Med.,2017,376(11):1086-1087.CrossRefPubMed
12.
go back to reference Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med (Zagreb). 2021;31(1):010502.CrossRefPubMed Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med (Zagreb). 2021;31(1):010502.CrossRefPubMed
14.
go back to reference Tinterri C, Canavese G, Gatzemeier W, Barbieri E, Bottini A, Sagona A, et al. Sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer patients undergoing mastectomy with one to two metastatic sentinel lymph nodes: sub-analysis of the SINODAR-ONE multicentre randomized clinical trial and reopening of enrolment. Br J Surg. 2023;110(9):1143–52.CrossRefPubMedPubMedCentral Tinterri C, Canavese G, Gatzemeier W, Barbieri E, Bottini A, Sagona A, et al. Sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer patients undergoing mastectomy with one to two metastatic sentinel lymph nodes: sub-analysis of the SINODAR-ONE multicentre randomized clinical trial and reopening of enrolment. Br J Surg. 2023;110(9):1143–52.CrossRefPubMedPubMedCentral
15.
go back to reference Tinterri C, Sagona A, Barbieri E, Di Maria GS, Caraceni G, Ambrogi G, et al. Sentinel Lymph Node Biopsy in Breast Cancer Patients Undergoing Neo-Adjuvant Chemotherapy: Clinical Experience with Node-Negative and Node-Positive Disease Prior to Systemic Therapy. Cancers (Basel). 2023;15(6) Tinterri C, Sagona A, Barbieri E, Di Maria GS, Caraceni G, Ambrogi G, et al. Sentinel Lymph Node Biopsy in Breast Cancer Patients Undergoing Neo-Adjuvant Chemotherapy: Clinical Experience with Node-Negative and Node-Positive Disease Prior to Systemic Therapy. Cancers (Basel). 2023;15(6)
16.
go back to reference Michalik T, Matkowski R, Biecek P, Szynglarewicz B. The use of ultrasonic dissectors lowers the risk of post-mastectomy seroma formation in obese women. J Cancer. 2019;10(15):3481–5.CrossRefPubMedPubMedCentral Michalik T, Matkowski R, Biecek P, Szynglarewicz B. The use of ultrasonic dissectors lowers the risk of post-mastectomy seroma formation in obese women. J Cancer. 2019;10(15):3481–5.CrossRefPubMedPubMedCentral
17.
go back to reference Memon F, Ahmed A, et al. Outcomes of Harmonic Scalpel and Electrocautery in Patients Who Underwent Modified Radical Mastectomy. Cureus. 2020;12(12):e12311.PubMedPubMedCentral Memon F, Ahmed A, et al. Outcomes of Harmonic Scalpel and Electrocautery in Patients Who Underwent Modified Radical Mastectomy. Cureus. 2020;12(12):e12311.PubMedPubMedCentral
18.
go back to reference Rohaizak M, Khan FJ, et al. Ultracision versus electrocautery in performing modified radical mastectomy and axillary lymph node dissection for breast cancer: a prospective randomized control trial. Med J Malaysia. 2013;68(3):204–7.PubMed Rohaizak M, Khan FJ, et al. Ultracision versus electrocautery in performing modified radical mastectomy and axillary lymph node dissection for breast cancer: a prospective randomized control trial. Med J Malaysia. 2013;68(3):204–7.PubMed
19.
go back to reference Zhang Z, Li L, et al. Comparison of harmonic scalpel and conventional technique in the surgery for breast cancer: A systematic review and meta-analysis. Indian J Cancer. 2018;55(4):348–58.CrossRefPubMed Zhang Z, Li L, et al. Comparison of harmonic scalpel and conventional technique in the surgery for breast cancer: A systematic review and meta-analysis. Indian J Cancer. 2018;55(4):348–58.CrossRefPubMed
20.
go back to reference Huang J, Yu Y, et al. Harmonic Scalpel versus Electrocautery Dissection in Modified Radical Mastectomy for Breast Cancer: A Meta-Analysis. PLoS One. 2015;10(11):e0142271.CrossRefPubMedPubMedCentral Huang J, Yu Y, et al. Harmonic Scalpel versus Electrocautery Dissection in Modified Radical Mastectomy for Breast Cancer: A Meta-Analysis. PLoS One. 2015;10(11):e0142271.CrossRefPubMedPubMedCentral
21.
go back to reference Faisal M, Fathy H, et al. A novel technique of harmonic tissue dissection reduces seroma formation after modified radical mastectomy compared to conventional electrocautery: a single-blind randomized controlled trial. Patient Saf Surg. 2018;17(12):8.CrossRef Faisal M, Fathy H, et al. A novel technique of harmonic tissue dissection reduces seroma formation after modified radical mastectomy compared to conventional electrocautery: a single-blind randomized controlled trial. Patient Saf Surg. 2018;17(12):8.CrossRef
22.
go back to reference Kiyingi AK, Macdonald LJ, Shugg SA, Bollard RC. Harmonic dissection versus electrocautery in breast surgery in regional Victoria. ANZ J Surg. 2015;85(5):358–62.CrossRefPubMed Kiyingi AK, Macdonald LJ, Shugg SA, Bollard RC. Harmonic dissection versus electrocautery in breast surgery in regional Victoria. ANZ J Surg. 2015;85(5):358–62.CrossRefPubMed
23.
go back to reference Shanmugam S, Govindasamy G, et al. Axillary dissection for breast cancer using electrocautery versus ultrasonic dissectors: A prospective randomized study. Indian J Cancer. 2017;54(3):543–6.CrossRefPubMed Shanmugam S, Govindasamy G, et al. Axillary dissection for breast cancer using electrocautery versus ultrasonic dissectors: A prospective randomized study. Indian J Cancer. 2017;54(3):543–6.CrossRefPubMed
24.
go back to reference Gambardella C, Clarizia G, et al. Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation. BMC Surg. 2019;18(Suppl 1):125.CrossRefPubMedPubMedCentral Gambardella C, Clarizia G, et al. Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation. BMC Surg. 2019;18(Suppl 1):125.CrossRefPubMedPubMedCentral
25.
go back to reference Isozaki H, Yamamoto Y, et al. Impact of the surgical modality for axillary lymph node dissection on postoperative drainage and seroma formation after total mastectomy. Patient Saf Surg. 2019;14(13):20.CrossRef Isozaki H, Yamamoto Y, et al. Impact of the surgical modality for axillary lymph node dissection on postoperative drainage and seroma formation after total mastectomy. Patient Saf Surg. 2019;14(13):20.CrossRef
26.
go back to reference Kim KE, Park H, Bae SH, Hwang BY, Kang T. Usefulness of using additional ultrasonic dissection device in breast cancer surgery: a retrospective cohort study. Gland Surg. 2021 10(12):3181-3187 pii: gs-10-12-3181. Kim KE, Park H, Bae SH, Hwang BY, Kang T. Usefulness of using additional ultrasonic dissection device in breast cancer surgery: a retrospective cohort study. Gland Surg. 2021 10(12):3181-3187 pii: gs-10-12-3181.
27.
go back to reference Li Chuanxing, Wang Cunchuan, Xu Guoliang, et al. Comparative experimental study on vascular sealing by ultrasonic hemostatic knife and electric knife in laparoscopic surgery. Chin J Endos.,2001,7(6):42-44. Li Chuanxing, Wang Cunchuan, Xu Guoliang, et al. Comparative experimental study on vascular sealing by ultrasonic hemostatic knife and electric knife in laparoscopic surgery. Chin J Endos.,2001,7(6):42-44.
28.
go back to reference Abi Antoun M, Etrusco A, Chiantera V, Laganà AS, Feghali E, Khazzaka A, et al. Outcomes of conventional and advanced energy devices in laparoscopic surgery: a systematic review. Minim Invasive Ther Allied Technol. 2024;2:1–12.CrossRef Abi Antoun M, Etrusco A, Chiantera V, Laganà AS, Feghali E, Khazzaka A, et al. Outcomes of conventional and advanced energy devices in laparoscopic surgery: a systematic review. Minim Invasive Ther Allied Technol. 2024;2:1–12.CrossRef
29.
go back to reference Chang JE, Kim H, Han SH, et al. Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation. Anesth Analg. 2017;125(4):1240–5.CrossRefPubMed Chang JE, Kim H, Han SH, et al. Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation. Anesth Analg. 2017;125(4):1240–5.CrossRefPubMed
30.
go back to reference Bonnema J, Ligtenstein DA, Wiggers T, van Geel AN. The composition of serous fluid after axillary dissection. Eur J Surg. 1999;165(1):9–13.CrossRefPubMed Bonnema J, Ligtenstein DA, Wiggers T, van Geel AN. The composition of serous fluid after axillary dissection. Eur J Surg. 1999;165(1):9–13.CrossRefPubMed
31.
go back to reference Marill KA. Advanced statistics: linear regression, part II: multiple linear regression. Acad Emerg Med. 2004;11(1):94–102.CrossRefPubMed Marill KA. Advanced statistics: linear regression, part II: multiple linear regression. Acad Emerg Med. 2004;11(1):94–102.CrossRefPubMed
32.
go back to reference Adrien C, Katia M, Marie-Lucile B, Alice R, Claire B, Roman R. Prevention of lymphocele or seroma after mastectomy and axillary lymphadenectomy for breast cancer: systematic review and meta-analysis. Sci Rep. 2022;12(1):10016.CrossRefPubMedPubMedCentral Adrien C, Katia M, Marie-Lucile B, Alice R, Claire B, Roman R. Prevention of lymphocele or seroma after mastectomy and axillary lymphadenectomy for breast cancer: systematic review and meta-analysis. Sci Rep. 2022;12(1):10016.CrossRefPubMedPubMedCentral
33.
go back to reference Abouelazayem M, Elkorety M, Monib S. Breast Lymphedema After Conservative Breast Surgery: An Up-to-date Systematic Review. Clin Breast Cancer. 2021;21(3):156–61.CrossRefPubMed Abouelazayem M, Elkorety M, Monib S. Breast Lymphedema After Conservative Breast Surgery: An Up-to-date Systematic Review. Clin Breast Cancer. 2021;21(3):156–61.CrossRefPubMed
34.
go back to reference Ge I, Erbes T, Juhasz-Böss I. Prognostic value and management of regional lymph nodes in locoregional breast cancer recurrence: a systematic review of the literature. Arch Gynecol Obstet. 2022;306(4):943–57.CrossRefPubMedPubMedCentral Ge I, Erbes T, Juhasz-Böss I. Prognostic value and management of regional lymph nodes in locoregional breast cancer recurrence: a systematic review of the literature. Arch Gynecol Obstet. 2022;306(4):943–57.CrossRefPubMedPubMedCentral
35.
go back to reference Ashikaga T, Krag DN, Land SR, et al. Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection. J Surg Oncol. 2010;102(2):111–8.CrossRefPubMedPubMedCentral Ashikaga T, Krag DN, Land SR, et al. Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection. J Surg Oncol. 2010;102(2):111–8.CrossRefPubMedPubMedCentral
36.
go back to reference Reimer T, Hartmann S, Stachs A, Gerber B. Local treatment of the axilla in early breast cancer: concepts from the national surgical adjuvant breast and bowel project B-04 to the planned intergroup sentinel mamma trial. Breast Care (Basel). 2014;9(2):87–95.CrossRefPubMedPubMedCentral Reimer T, Hartmann S, Stachs A, Gerber B. Local treatment of the axilla in early breast cancer: concepts from the national surgical adjuvant breast and bowel project B-04 to the planned intergroup sentinel mamma trial. Breast Care (Basel). 2014;9(2):87–95.CrossRefPubMedPubMedCentral
37.
go back to reference Gentilini O, Botteri E, Dadda P, et al. Physical function of the upper limb after breast cancer surgery. Results from the SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial. Eur J Surg Oncol. 2016;42(5):685–9.CrossRefPubMed Gentilini O, Botteri E, Dadda P, et al. Physical function of the upper limb after breast cancer surgery. Results from the SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial. Eur J Surg Oncol. 2016;42(5):685–9.CrossRefPubMed
Metadata
Title
Comparison of the effect of ultrasounic-harmonic scalpel and electrocautery in the treatment of axillary lymph nodes during radical surgery for breast cancer
Authors
Yujia Tian
Lifei Han
Xiao Ma
Rui Guo
Zhuoga GeSang
Yabo Zhai
Haolin Hu
Publication date
01-12-2024
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2024
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-024-03381-x

Other articles of this Issue 1/2024

World Journal of Surgical Oncology 1/2024 Go to the issue