Comparative Study of Harmonic Scalpel versus Electrocautery in MRM
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 8
Abstract
Abstract:Breast cancer is one of the most common carcinoma in the female population. Several combinations of surgery, radiotherapy, chemotherapy and hormonal immunotherapy are being used for treatment of carcinoma breast. Conventional MRM using electro-cautery is associated with a certain loss of blood and a moderate degree of operative morbidity. Ultrasonic dissection using the harmonic scalpel has recently emerged as a safe alternative to electro-cautery. The aim of the study is to compare the efficacy, safety and differences in blood loss, operative time, intra and postoperative complications of ultrasonic harmonic scalpel and electro-cautery in performing Modified Radical Mastectomy. This study has been conducted during year 2016-2017 in 30 patients of carcinoma breast of any age group in the department of General Surgery SMS Medical College and hospital Jaipur, Rajasthan. An analytic study to compare the outcome in MRM in group one using ultrasonic harmonic scalpel and group two electro-cautery was done. The result of our study showed median blood loss was 140 ml in harmonic scalpel group while 320 ml in electro-cautery group. Blood loss in harmonic scalpel group was significantly less compared to electro cautery group (p-value <0.001 on applying Mann-whitnney U test). Number of drain days was significantly less in harmonic scalpel group compared to electro-cautery group (p-value <0.001 on applying Mann-whitnney U test). Drain output was also significantly less in harmonic scalpel group compared to electro cautery group (p-value <0.001 on applying Mann-whitnney U test). There was no significant difference in weight of excised specimen, operative time, post operative pain, seroma formation and flap necrosis in both groups. So we concluded that Harmonic scalpel is a newer innovative device being used for dissection and haemostasis in MRM. Use of harmonic scalpel for MRM significantly reduces blood loss, post operative drain output in comparison to electro cautery. Time taken for performing surgery using Harmonic Scalpel is comparable to Electro Cautery and even shorter in experienced hands. Though the cost of the equipment may be a constraint in its wide use yet it is wise to recommend use of harmonic scalpel in performing modified radical mastectomy. Keywords:Electro cautery, Harmonic scalpel, Modified Radical Mastectomy (MRM)
Authors and Affiliations
Sunil Pabri1, Sudarshan Gothwa, Farukh Khan
Keywords
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