A trial shows the efficacy of patches to reduce postoperative seroma after lymph node removal

VALENCIA, July 27 (EUROPA PRESS) -

The Incliva Health Research Institute, of the Hospital Clínico de València, has conducted a clinical trial that has shown the effectiveness of the insertion of Polyethylene glycol patches in the cavity obtained after the removal of axillary lymph nodes in patients with breast cancer, such as alternative to the usual suction drains in the postoperative period.

These drains mean a greater number of hospital visits, due to discomfort due to pain and the risk of spontaneous exit of the drainage tube, development of seroma -a serous liquid, coming from the blood plasma, which accumulates under the incision- - and even bleeding, and also a greater number of infections, which have a negative impact on the quality of life of these patients, Incliva reported in a statement.

The Polyethylene glycol patch is a hemostatic sealant that is applied directly to moist tissue --in this case, the axillary space-- combining two processes: sealing the surface and reducing bleeding.

Los resultados de este ensayo acaban de publicarse recientemente en British Journal of Surgery, en el artículo ‘Clinical and cost outcomes of a polyethylene glycol (PEG)-coated patch versus drainage after axillary lymph node dissection in breast cancer: results from a multicentre randomized clinical trial’.

The principal investigator of this study was Dr. Elvira Buch, from the Incliva Breast Cancer Biology Research Group; Head of the Department of General Surgery and Coordinator of the Breast Unit at the Hospital Clínico de València; and associate professor at the CEU Cardenal Herrera University.

This multicenter, randomized and prospective study was carried out throughout the Spanish territory with the participation, in addition to Incliva, of the Surgery Departments of the Hospital Clínico, Hospital General and Hospital La Fe, from Valencia; General Hospital of Alicante; Requena Hospital; Clinical Hospital of Santiago de Compostela; Antequera Hospital (Malaga); San Pedro Hospital (Logroño); and the Marqués de Valdecilla Clinical Hospital (Santander); in addition to the Valencian Institute of Oncology (IVO).

Dr Buch explained that the aim of the trial was to see if patients with axillary lymphadenectomy could be spared from wearing the drain postoperatively, "in order to improve their quality of life in the weeks following surgery."

Axillary lymphadenectomy or axillary dissection is a surgery performed in the armpit area to evaluate the lymph nodes affected by breast cancer and, thus, to be able to decide on the best cancer treatment. When a person has breast cancer, cancer cells may spread through the lymphatic system and reach these nodes.

The starting point for this trial were studies in other pathologies that decreased postoperative seroma, which affects between 30% and 40% of women with breast cancer who underwent axillary lymphadenectomy, causing swelling in the area that generates them. discomfort to move the arm, makes rehabilitation exercises after surgery impossible and may even be the reason for delaying cancer treatments after surgical treatment.

The purpose was to try to avoid suction drainage that was performed on all women in the postoperative period, given their complaints about discomfort, in addition to assessing the decrease or increase in seroma with the patch and drain. The study began in 2020 with the recruitment of patients. Almost 250 women with breast-conserving surgery (without breast removal) participated in two study groups.