Comparison of Postoperative Outcomes of Modified Radical Mastectomy (MRM) with and without Tumescent Technique

Mastectomy with and without Tumescent Technique

Abstract

Background: Modified radical mastectomy (MRM) is one of the common surgical approaches to breast cancer. The tumescent technique could help to reduce postoperative morbidity and enhance operative efficiency. Objective: To compare postoperative results of MRM with and without using the tumescent technique. Study Design: Randomized, controlled trial. Settings: Department of Surgery, Allied Hospital, Faisalabad, Pakistan. Duration: One year from 01-04-2023 to 31-03-2024. Methods: This was a randomized, comparative study of 230 female patients undergoing MRM, divided into 2 groups of 115 patients. The tumescent technique was used in Group A, and conventional MRM in Group B. Demographic variables, tumor characteristics, operative duration, and postoperative complications were recorded. Data was analyzed using SPSS v. 25.0. For categorical variables, the chi-square test was used, while the independent t-test was used for continuous variables (p < 0.05). Results: In several categories, the results were much better with the tumescent method. The operative time was significantly shorter in the tumescent group, with 28.7% of cases taking less than 90 minutes, compared with 50.4% of the conventional group taking more than 120 minutes (p < 0.001). There were fewer cases of seroma in the tumescent group (7.0%) than in the conventional group (16.5%) (p = 0.024). Finally, there was a trend toward decreased wound infection in the tumescent group (6.1% vs 10.4%), but this difference was not statistically significant (p = 0.231). The incidence of hematoma and flap necrosis did not differ between the tumescent and conventional groups, and only 3.5% of the conventional group experienced these complications (p = 0.044). Stratified analysis showed greater benefit in obese patients (5.6% vs 24.2%, p = 0.028) and ASA-III patients (2.9% vs 18.6%, p = 0.030). Conclusion: The tumescent technique results in a significant reduction of operative time, seroma formation, hematoma, and flap necrosis, especially in high-risk patients in MRM.