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allied
academies
February 25-26, 2019 | Paris, France
13
th
World Cancer Congress
Journal of Medical Oncology and Therapeutics | Volume 4
Irrigation of the axillary bed with antibiotic solutions after lymph node dissection and the reduction
of lymphedema and oncologic outcome
Jaime Ruiz-Tovar
Garcilaso Clinic, Spain
T
he placement of a drain in the axillary bed after lymph
node dissection secondary to breast cancer, is focused
on the avoidance of seroma. Several studies of our group
have demonstrated that the topical antibiotic irrigation
(gentamycin and clindamycin) reduces the drainage volume.
The purpose of this study was to evaluate the effect of
axillary lavage with a gentamicin and clindamycin solution
on the oncologic outcome.
Patients and Methods:
A prospective, randomized study
was performed. Inclusion criteria were a diagnosis of breast
neoplasms and plans to undergo an elective axillary lymph
node dissection due to axillary metastasis. The patients were
randomized into 2 groups: patients undergoing a lavage with
500ml normal saline(Group 1) and patients undergoing a lavage
with a 500ml of a gentamicin(240mg) solution(Group 2).
Results:
80 patients were included. Mean number of days
maintaining the drain in place was 7.7+3.2 days in Group
1 and 4.3+1.4 days in Group 2(p=0.001). Total drainage
volume before removal was 465+250.9ml in Group 1 and
169+102.2ml in Group 2(p=0.003).
After a minimum follow-up of 60 months, mean disease-free
survival was 37.2 + 14.2 months in Group 1 and 25.8 + 16.3
months in Group 2 (Mean difference 11.4; CI95% (2.2-25.1);
p=0.009). Mean global survival was 44.2 + 11.9 months in
Group 1 and 34.1 + 14.1 months in Group 2 (Mean difference
10.1; CI95% (2.2-18);p=0.016).
The postoperative drainage volume of the axillary drain
is significantly lower in the patients undergoing a lavage
of the surgical bed with a gentamicin solution than in the
control group undergoing a lavage with normal saline. The
lavage with gentamicin increases the disease-free and global
survival colorectal tumours.
e:
jruiztovar@gmail.com