Interest of the Padding in the Prevention of Lymphocele Production after Mastectomy with Axillary Dissection for Breast Cancer at Joliot Curie Cancer Center

Abstract

Introduction: The principal postoperative complication of mastectomies with axillary dissection is the lymphocele that can last many months after surgery. The purpose of our study was to prevent its formation using the padding. Methods: Sixty-one patients have been included in our study. The follow-up was 6 months. The patients were divided in two groups through a random draw (simple drainage and drainage associated with padding). All patients had a mastectomy with axillary dissection following the Madden technique. All quantities of lymphoceles during postoperative hospitalization and ambulatory care have been noted. Results: Twenty-five patients had benefited f rom the padding and 36 of a simple axillary drainage. Six months after the surgery, the patients benefitting from the padding had a quantity of lymphocele equal to half that of the control group (761.83 mL against 1373.60 mL; p = 0.01). During the postoperative hospitalization, the quantities were of 362.80 mL for the padding group versus 630.83 mL; p < 0.01. The hospitalization period was shorter for the padding patients (3.72 days vs 5.14 days; p = 0.01). However, pain was greater for the padding group upon 6 months (0.26 vs 0.10; p = 0.04). On another note, padding does not influence the duration of the surgery. Conclusion: The production of postoperative lymphocele is heterogenous, varying from one patient to another. Nevertheless, the padding of the mastectomy compartment and of the axillary cavity allow s a noticeable reduction of the produced quantity and of the hospitalization period at the expense of more pain.