~ 149 ~ International Journal of Surgery Science 2019; 3(1): 149-153 E-ISSN: 2616-3470 P-ISSN: 2616-3462 © Surgery Science www.surgeryscience.com 2019; 3(1): 149-153 Received: 22-11-2018 Accepted: 24-12-2018 Anil Kumar Sharma Assistant Professor, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India Mukesh Kumar Postgraduate Resident, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India Amit Singh Assistant Professor, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India Rekha Porwal Senior Professor and H.O.D, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India Shruti K Somani Postgraduate Resident, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India Aakanksha Soni Postgraduate Resident, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India Correspondence Amit Singh Assistant Professor, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan, India A prospective randomized study comparing ultrasonic dissector with monopolar electrocautery for dissection in modified radical mastectomy Anil Kumar Sharma, Mukesh Kumar, Amit Singh, Rekha Porwal, Shruti K Somani and Aakanksha Soni DOI: https://doi.org/10.33545/surgery.2019.v3.i1c.28 Abstract 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. Keywords: Breast carcinoma, electrocautery, harmonic focus, modified radical mastectomy, ultrasonic dissector Introduction Breast carcinoma is the most frequently diagnosed cancer among women in world about 25.2% all cancer [1] while in India accounts 27% of all cancer [2] in women. As long term survival of breast cancer patients depends on stage of breast carcinoma at time of presentation, one of the main focuses of breast cancer management lies within the axillary region, as one of the primary metastatic pathways. Therefore axillary lymph node involvement is one of the most important prognostic factors (in patients with breast cancer) and axillary lymph node dissection has become a standard procedure within breast cancer treatment. Surgical treatment for breast cancer has shifted dramatically from radical operations to breast conserving surgical techniques. Modified radical mastectomy remains the most frequently performed surgical procedure for breast cancer. The present study is designed to compare the efficacy and safety of ultrasonic dissector with electrocautery for dissection in modified radical mastectomy (MRM). Method A prospective randomized study of 70 patients of carcinoma breast was conducted at J.L.N. Medical College and Hospital, Ajmer. The candidates for the study were cases of carcinoma breast undergoing modified radical mastectomy (MRM). All the 70 cases of carcinoma breast who met the inclusion and exclusion criteria of the study were allocated to either group A (Dissection using ultrasonic dissector) or group B (Dissection using electrocautery) by simple random technique through opaque sealed envelope technique.