Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure

Background: Conventional monopolar electrocautery in level-II axillary lymph-node dissection is associated with seroma formation and thermal injury. LigaSure, an electrothermal bipolar vessel-sealing system, may reduce postoperative drainage. The study aimed to compare axillary drain output after l...

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Main Authors: Farkhanda Niaz, Muhammad Umair Afzal, Rashid Iqbal, Adnan Ahmed Raza, Rabbia Abdul Ghani, Abrar Ahmad
Format: Article
Language:English
Published: ziauddin University 2025-07-01
Series:Pakistan Journal of Medicine and Dentistry
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Online Access:https://ojs.zu.edu.pk/pjmd/article/view/3773
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author Farkhanda Niaz
Muhammad Umair Afzal
Rashid Iqbal
Adnan Ahmed Raza
Rabbia Abdul Ghani
Abrar Ahmad
author_facet Farkhanda Niaz
Muhammad Umair Afzal
Rashid Iqbal
Adnan Ahmed Raza
Rabbia Abdul Ghani
Abrar Ahmad
author_sort Farkhanda Niaz
collection DOAJ
description Background: Conventional monopolar electrocautery in level-II axillary lymph-node dissection is associated with seroma formation and thermal injury. LigaSure, an electrothermal bipolar vessel-sealing system, may reduce postoperative drainage. The study aimed to compare axillary drain output after level II dissection using electrocautery vs. Ligasure. Methods: In this quasi-experimental study, 60 women with breast cancer undergoing level-II axillary lymph node dissection at Allied Hospital, Faisalabad, were allocated to monopolar electrocautery (Group A) or LigaSure (Group B) from 1st October 2023 to 30th March 2024. A non-probability consecutive sampling technique was used. Axillary drain output was the primary endpoint. Age, body mass index, duration of surgery, number of nodes removed, diabetes, hypertension, residence, radiotherapy, and chemotherapy status were recorded. Data were analyzed in SPSS v25.0. Quantitative variables were expressed as mean ± SD; categorical variables as frequency (%). Mean drain output between groups was compared with an independent-samples t-test, and p≤ 0.05 was considered significant. Results: Mean age was 52.2 ± 7.2 years in Group A and 49.1 ± 7.1 years in Group B; mean BMI was 28.9 ± 2.4 kg/m². Average surgery time was 78.8 ± 7.5 min with 3.4 ± 0.9 nodes excised. Group A showed significantly higher drain output (290.0 ± 40.0 mL) than Group B (164.6 ± 18.0 mL); mean difference = −125.4 mL (p < 0.001). Conclusion: LigaSure markedly reduces postoperative axillary drainage compared with monopolar electrocautery during level-II ALND, supporting its routine use to minimize seroma risk in breast-cancer surgery.
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publishDate 2025-07-01
publisher ziauddin University
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spelling doaj-art-5cf20f75a4cd46dc9ee7ea89b37579cf2025-08-20T03:08:32Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-07-0114310.36283//ziun-pjmd14-3/003Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSureFarkhanda Niaz0https://orcid.org/0009-0001-7895-8783Muhammad Umair Afzal1https://orcid.org/0009-0009-7036-5738Rashid Iqbal2https://orcid.org/0009-0003-7264-0023Adnan Ahmed Raza3https://orcid.org/0009-0001-9926-385XRabbia Abdul Ghani4https://orcid.org/0009-0007-5503-1356Abrar Ahmad5https://orcid.org/0009-0005-6747-0191 Allied Hospital Faisalabad and Central park Medical college and Teaching Hospital Lahore, Pakistan.Shifa International Hospital, Jaranwala Road, Faisalabad,Pakistan.Central park Medical College and Teaching Hospital, Lahore,PakistanAziz Fatima Medical & Dental College, Faisalabad, Pakistan.Aziz Fatima Medical & Dental College, Faisalabad, Pakistan.Services Hospital Lahore, Pakistan. Background: Conventional monopolar electrocautery in level-II axillary lymph-node dissection is associated with seroma formation and thermal injury. LigaSure, an electrothermal bipolar vessel-sealing system, may reduce postoperative drainage. The study aimed to compare axillary drain output after level II dissection using electrocautery vs. Ligasure. Methods: In this quasi-experimental study, 60 women with breast cancer undergoing level-II axillary lymph node dissection at Allied Hospital, Faisalabad, were allocated to monopolar electrocautery (Group A) or LigaSure (Group B) from 1st October 2023 to 30th March 2024. A non-probability consecutive sampling technique was used. Axillary drain output was the primary endpoint. Age, body mass index, duration of surgery, number of nodes removed, diabetes, hypertension, residence, radiotherapy, and chemotherapy status were recorded. Data were analyzed in SPSS v25.0. Quantitative variables were expressed as mean ± SD; categorical variables as frequency (%). Mean drain output between groups was compared with an independent-samples t-test, and p≤ 0.05 was considered significant. Results: Mean age was 52.2 ± 7.2 years in Group A and 49.1 ± 7.1 years in Group B; mean BMI was 28.9 ± 2.4 kg/m². Average surgery time was 78.8 ± 7.5 min with 3.4 ± 0.9 nodes excised. Group A showed significantly higher drain output (290.0 ± 40.0 mL) than Group B (164.6 ± 18.0 mL); mean difference = −125.4 mL (p < 0.001). Conclusion: LigaSure markedly reduces postoperative axillary drainage compared with monopolar electrocautery during level-II ALND, supporting its routine use to minimize seroma risk in breast-cancer surgery. https://ojs.zu.edu.pk/pjmd/article/view/3773Breast NeoplasmsMastectomyAxillaLymph Node ExcisionElectrosurgery
spellingShingle Farkhanda Niaz
Muhammad Umair Afzal
Rashid Iqbal
Adnan Ahmed Raza
Rabbia Abdul Ghani
Abrar Ahmad
Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure
Pakistan Journal of Medicine and Dentistry
Breast Neoplasms
Mastectomy
Axilla
Lymph Node Excision
Electrosurgery
title Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure
title_full Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure
title_fullStr Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure
title_full_unstemmed Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure
title_short Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure
title_sort comparison of axillary drain output after level 2 dissection using monopolar electrocautery versus ligasure
topic Breast Neoplasms
Mastectomy
Axilla
Lymph Node Excision
Electrosurgery
url https://ojs.zu.edu.pk/pjmd/article/view/3773
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