Aim: The present study is designed to compare the efficacy and safety of ultrasonic dissector with monopolar electrocautery for dissection in modified radical mastectomy in terms of lymph vessels sealing, haemostasis, intra-operative and post-operative complications and hospital stay in patients of carcinoma breast.
Method: A prospective randomized controlled study of 70 patients of carcinoma breast was conducted at J.L.N. Medical College, Ajmer. The patients assigned in to two groups (35 in each) through randomization. Dissection in modified radical mastectomy was done by either ultrasonic dissector or monopolar electrocautery according to group allocation. Data was collected prospectively and analysed.
Results: Time for dissection and total duration of surgery, intra-operative blood loss, drainage volume, duration of drain and stay in hospital was significantly less while using ultrasonic dissector compared to using electrocautery. This was found statistically significant (p<0.05). But no statistically significant differences were found in intra-operative complications and post-operative complications (like flap necrosis found in 5.7% patients with ultrasonic dissector and in 2.9% patients with electrocautery.
Conclusion: From our study, we can conclude that the ultrasonic dissector is as safe and effective as the electrocautery and its use has significant advantages over electrocautery in term of reduction of operative time, blood loss, post-operative drain volume and the number of days the drain was kept in situ and thereby the length of hospital stay. There was however no significant difference in the incidence of post-operative complications.