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<p>Axillary lymph node dissection (ALND) is an essential component of surgical management in breast cancer. Electrocautery (EC), Harmonic Scalpel (HS), and LigaSure™ (LS) are commonly used surgical devices, but limited studies have directly compared their outcomes in ALND. This study aimed to prospectively compare Electrocautery (EC), Harmonic Scalpel (HS), and LigaSure™ (LS) for axillary lymph node dissection (ALND) in breast cancer surgery. The primary objective was to evaluate differences in operative time, intraoperative blood loss, postoperative drain output, drain removal time, seroma formation, and lymph node yield across the three techniques. Secondary objectives included assessing early postoperative complications and long-term lymphedema. A prospective observational study was conducted from June 2020 to March 2023 at a single center, including 150 operable breast cancer patients undergoing ALND. Patients were sequentially allocated into three groups (<i>n</i> = 50 each): EC, HS, and LS. Standardized surgical techniques and postoperative protocols were followed. Data on perioperative outcomes and complications were collected and statistically analyzed. LigaSure had the longest operative time (43.2 ± 2.98 min) but the least blood loss (48.6 ± 3.67 ml). Both HS and LS showed significantly reduced postoperative drain output (428.0 ± 61.7 ml and 416.1 ± 68.5 ml) and earlier drain removal (10.67 ± 2.34 and 10.27 ± 2.49 days) compared to EC (510.8 ± 79.9 ml; 13.69 ± 2.90 days) (<i>p</i> &lt; 0.0001). Seroma formation was more frequent in the EC group (28%) than HS (12%) and LS (8%), though not statistically significant. Lymph node yield and complication rates were comparable. No lymphedema was reported during follow-up. Both Harmonic Scalpel and LigaSure significantly reduced intraoperative and postoperative morbidity compared to Electrocautery, while maintaining equivalent oncological outcomes. These advanced energy devices are safe and efficient alternatives for ALND in breast cancer surgery.</p>

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A Prospective Comparative Study on Assessment of Outcomes of Axillary Lymph Node Dissection for Carcinoma of Breast Using Electrocautery, Harmonic Focus, and Ligasure

  • 期刊论文

  • 发表日期：

    2025年12月20日

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  • Kawadu Jawade,
  • Rahul Gupta,
  • A. K. Dewan

摘要

Axillary lymph node dissection (ALND) is an essential component of surgical management in breast cancer. Electrocautery (EC), Harmonic Scalpel (HS), and LigaSure™ (LS) are commonly used surgical devices, but limited studies have directly compared their outcomes in ALND. This study aimed to prospectively compare Electrocautery (EC), Harmonic Scalpel (HS), and LigaSure™ (LS) for axillary lymph node dissection (ALND) in breast cancer surgery. The primary objective was to evaluate differences in operative time, intraoperative blood loss, postoperative drain output, drain removal time, seroma formation, and lymph node yield across the three techniques. Secondary objectives included assessing early postoperative complications and long-term lymphedema. A prospective observational study was conducted from June 2020 to March 2023 at a single center, including 150 operable breast cancer patients undergoing ALND. Patients were sequentially allocated into three groups (n = 50 each): EC, HS, and LS. Standardized surgical techniques and postoperative protocols were followed. Data on perioperative outcomes and complications were collected and statistically analyzed. LigaSure had the longest operative time (43.2 ± 2.98 min) but the least blood loss (48.6 ± 3.67 ml). Both HS and LS showed significantly reduced postoperative drain output (428.0 ± 61.7 ml and 416.1 ± 68.5 ml) and earlier drain removal (10.67 ± 2.34 and 10.27 ± 2.49 days) compared to EC (510.8 ± 79.9 ml; 13.69 ± 2.90 days) (p < 0.0001). Seroma formation was more frequent in the EC group (28%) than HS (12%) and LS (8%), though not statistically significant. Lymph node yield and complication rates were comparable. No lymphedema was reported during follow-up. Both Harmonic Scalpel and LigaSure significantly reduced intraoperative and postoperative morbidity compared to Electrocautery, while maintaining equivalent oncological outcomes. These advanced energy devices are safe and efficient alternatives for ALND in breast cancer surgery.