CClinicalTrials.gg
CompletedNCT03166384ELBCEUpdated Sep 8, 2023

ELectrosurgical Bipolar Devices VS Conventional Electro-cauterization in Breast Surgery

An interventional study of electrosurgical bipolar sealing devices and conventional suture and tie in Seroma as Procedural Complication, sponsored by Severance Hospital. Completed at 1 site in Korea, Republic of. Open to female participants aged 20 Years to 100 Years. Per ClinicalTrials.gov, last updated 2023-09-08.

Sponsored by Severance Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
82
Allocation
Randomized
Ages
20 Years to 100 Years
Sex
Female
01

Study summary

There was no study about application of electrosurgical bipolar sealing device for mastectomy in Korean population, because Korean national insurance did not cover use of the advanced sealing device until last year. Sample size of the previous studies was too small to draw a solid conclusion. Therefore, this study was designed prospectively to evaluate whether application of bipolar energy device for mastectomy could provide clinical benefit in terms of reducing seroma formation.

Read the detailed description

Lymphorrhea and seroma are the most common complications of mastectomy in patients with breast cancer. Seroma formation increases admission period, follow-up duration, and postoperative discomforts. Repeated aspiration of seroma increases risk of re-admission due to wound infection. Seroma formation after mastectomy occurs in 10% to 85% of cases with mastectomy. Known risk factors according to previous studies are old age(>60 years), high BMI, tumor size, preoperative chemotherapy, surgical extent, and number of retrieved lymph nodes. To reduce postoperative complications including seroma formation, meticulous hemostasis and lymphatic ligation technique are necessary.

Procedures using new surgical devices such as bipolar sealing devices have been introduced. Electrosurgical bipolar sealing devices use the body's own collagen and elastin to create a permanent fusion zone through a combination of pressure and energy. Previous studies suggested that surgery using these devices lead to significant decrease of seroma formation, however their advantages are not well established in case of mastectomy for breast cancer. Several studies showed that an advanced sealing system like bipolar energy sealing system can reduce operative time and cost for postoperative management compared to conventional clamp and tie method in non-breast surgery.

If electrosurgical bipolar sealing devices are applied during mastectomy, there would be several potential benefits on vessel and lymphatic ligation. Conventional ligation and monopolar cauterization have several weak points including incompletion of ligation and thermal injury during procedures. On the other hand, electrosurgical bipolar sealing devices can provide a combination of pressure and energy simultaneously to minimize thermal injury and create a permanent fusion zone.

Previous studies suggested that electrosurgical bipolar sealing devices shortened removal time of drain after axillary lymph node dissection compared with conventional methods. Another study reported benefits on reducing blood loss, drainage amount, and length of hospital stay. Moreover, a recent study also reported that skin sparing mastectomy using electrosurgical bipolar sealing devices can be used in patients with breast cancer.

However, there are several limitations in previous studies. There was no study about application of electrosurgical bipolar sealing device for mastectomy in Korean population, because Korean national insurance did not cover use of the advanced sealing device until last year. Sample size of the previous studies was too small to draw a solid conclusion. Therefore, this study was designed prospectively to evaluate whether application of bipolar energy device for mastectomy could provide clinical benefit in terms of reducing seroma formation.

02

Conditions studied

  • Seroma as Procedural Complication

Browse trials for

Keywords

  • electrosurgical bipolar sealing devices, breast cancer
03

Who can participate

Ages eligible
20 Years to 100 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • 20 years old and over
  • Patients planned to undergo total mastectomy and axillary lymph node dissection
  • Patients planned to undergo total mastectomy and sentinel lymph node biopsy and/or reconstruction
  • Patients planned to undergo partial mastectomy and axillary lymph node dissection

Exclusion criteria

Exclusion Criteria:

  • Bilateral breast cancer patients
  • Male breast cancer patients
  • Patients who underwent ipsilateral axillar surgery or axillar radiation therapy
  • Recurrent breast cancer patients
  • Patients who cannot give informed consents such as non-Korean speakers and patients with intellectual disabilities
  • Vulnerable patients such as pregnant women for enrollment
  • Patients without drain catheter
  • Patients with Ductal carcinoma in situ who have not undergone ipsilateral sentinel lymph node biopsy or axillar lymph node dissection
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
82 participants (actual)

Study arms

  • Active comparator
    control group

    For the patients in the control group, surgeon dose not use electrosurgical bipolar sealing device at all and use conventional tie and ligation methods during tissue dissection and vessel ligation. interventions: 'conventional suture and tie'

    Procedure: conventional suture and tie

  • Experimental
    study group

    For the patients in the study group, the surgeon uses electrosurgical bipolar sealing device during tissue dissection and vessel ligation as much as possible. interventions: electrosurgical bipolar sealing devices

    Device: electrosurgical bipolar sealing devices

Interventions

  • Deviceelectrosurgical bipolar sealing devices

    Electrosurgical bipolar sealing devices use the body's own collagen and elastin to create a permanent fusion zone through a combination of pressure and energy. Previous studies suggested that surgery using these devices lead to significant decrease of seroma formation, however their advantages are not well established in case of mastectomy for breast cancer.

  • Procedureconventional suture and tie

    the surgeon uses electrosurgical bipolar sealing device during tissue dissection and vessel ligation as much as possible.

05

What researchers measure

Primary outcomes

  1. Total drainage volume after surgery: mL

    Total amount of drainage until drain tube removal Drain tube removal timing: When drainage volume is under 50mL/day for at least 2 days

    Time frame: Up to 30 weeks after surgery

Secondary outcomes

  1. Total exact drainage volume

    total amount volume of drainage bag and amount of aspiration from seroma after drain tube removal

    Time frame: Up to 30 weeks after surgery

  2. Drainage volume In hospital: mL

    Drainage volume In hospital: mL

    Time frame: Up to 30 weeks after surgery

  3. Total operation running time

    Total operation running time

    Time frame: Up to 30 weeks after surgery

  4. Complication ratio within a month after surgery

    possible pre-defined complications were defined in reference to previous studies

    Time frame: Up to 1 year after surgery

  5. Frequency of seroma aspiration

    examination for frequency and total amount of seroma aspiration within a month after surgery. Under 10mL/day, aspiration is stopped

    Time frame: Up to 30 weeks after surgery

06

Study locations

1 site
  • Yonsei University College of Medicine
    Seoul, 120-752, Korea, Republic of
07

References and documents

Publications

  • van Bemmel AJ, van de Velde CJ, Schmitz RF, Liefers GJ. Prevention of seroma formation after axillary dissection in breast cancer: a systematic review. Eur J Surg Oncol. 2011 Oct;37(10):829-35. doi: 10.1016/j.ejso.2011.04.012. Epub 2011 Aug 17. PubMed 21849243 ↗
  • Manouras A, Markogiannakis H, Genetzakis M, Filippakis GM, Lagoudianakis EE, Kafiri G, Filis K, Zografos GC. Modified radical mastectomy with axillary dissection using the electrothermal bipolar vessel sealing system. Arch Surg. 2008 Jun;143(6):575-80; discussion 581. doi: 10.1001/archsurg.143.6.575. PubMed 18559751 ↗
  • Nespoli L, Antolini L, Stucchi C, Nespoli A, Valsecchi MG, Gianotti L. Axillary lymphadenectomy for breast cancer. A randomized controlled trial comparing a bipolar vessel sealing system to the conventional technique. Breast. 2012 Dec;21(6):739-45. doi: 10.1016/j.breast.2012.08.003. Epub 2012 Sep 7. PubMed 22959311 ↗
  • Cortadellas T, Cordoba O, Espinosa-Bravo M, Mendoza-Santin C, Rodriguez-Fernandez J, Esgueva A, Alvarez-Vinuesa M, Rubio IT, Xercavins J. Electrothermal bipolar vessel sealing system in axillary dissection: a prospective randomized clinical study. Int J Surg. 2011;9(8):636-40. doi: 10.1016/j.ijsu.2011.08.002. Epub 2011 Sep 10. PubMed 21925293 ↗
  • Miyagi K, Rossi SH, Malata CM, Forouhi P. Novel use of LigaSure Impact electrosurgical bipolar vessel sealing system in skin-sparing mastectomy. J Plast Reconstr Aesthet Surg. 2015 Jun;68(6):e126-8. doi: 10.1016/j.bjps.2015.01.005. Epub 2015 Jan 26. No abstract available. PubMed 25682592 ↗
  • Park HS, Lee J, Kim JY, Park JM, Kwon Y. A Prospective Randomized Study to Compare Postoperative Drainage After Mastectomy Using Electrosurgical Bipolar Systems and Conventional Electro-Cautery. J Breast Cancer. 2022 Aug;25(4):307-317. doi: 10.4048/jbc.2022.25.e29. Epub 2022 Jun 27. PubMed 35914746 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03166384
Lead sponsor
Severance Hospital
Responsible party
Hyung Seok Park, MD, PhD (Clinical Assistant Professor, Severance Hospital) — Principal investigator
First posted
May 25, 2017
Start date
May 1, 2017
Primary completion
Mar 1, 2020
Completion
Jun 27, 2022
Last update
Sep 8, 2023

Study contacts

Hyung Seok Park, MD
study chair · Yonsei University College of Medicine, Korea

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion