Abstract P2-14-24: Argon scalpel in the surgical treatment of breast cancer
Authors: Giordano R , Bromberg S , Elias S , Nazário A , Waitzberg A , Sá R , Facina G 
Published: May 2019

Summary: Surgery is a key part of the treatment of breast cancer. The adoption of electric scalpel began to be used in breast surgeries in 1970 and this equipment uses high frequency electric current to create the following effects: cutting, coagulation or mixing of the two. Data show a decrease in the intraoperative bleeding, however, can also increase complications, such as seroma and thermal lesions in the surgical flaps. A new technique that could be used is the coagulation with argon plasma which is a method of non-contact thermal hemostasis.

Objectives: to compare the electric scalpel with the scalpel by coagulation with argon plasma about aspects surgical and pathological.

Methods: this is a prospective cohort study in which 60 patients with breast cancer were selected at the Discipline of Breast Diseases of the Department of Gynecology of the Federal University of São Paulo (UNIFESP) at any clinical stage where the surgical treatment was indicated, from March 2014 to August 2014. The patients were consecutively selected and randomized into two groups: electric scalpel surgery (ES) and argon plasma coagulation surgery (APC). Inclusion criteria were: 18 to 90 years old patients with breast cancer at any clinical stage where surgical (conservative or radical) treatment was indicated. Intraoperative bleeding was assessed by measuring the weights of the compresses. The patients who underwent surgery were evaluated at 7, 14 and 30 postoperative days. In these returns, the appearance of the surgical wound, the presence and amount of seroma (in mL), hematoma or infection were analyzed. Surgical site infection was considered when there was erythema, increased local or systemic temperature, pain, suture dehiscence or presence of purulent exudate. The surgical specimen was studied in the Department of Pathological Anatomy of UNIFESP. The pathological analysis as recommended by the WHO and particular evaluations were carried out in order to observe the extent and degree of the thermal effect produced in surgical specimens by the two hemostatic techniques (ES and APC).

Results: The mean age of the patients was 56.0 years for the ES group and 54.9 for the APC. There was no significant difference between the groups regarding intraoperative bleeding. However, a statistically significant difference was observed when the days with drain were compared in the postoperative period, with a mean of 10.1 days for the SE group and 7.1 days for the APC group. The study demonstrated that the APC group had a significant greater thermal effect on the margins of the surgical specimen.

Table 1.Thermal effect on the margins of the surgical specimens by study group (p=0.032)Thermic EffectEletric N (%)Argon N (%)Total N (%)Absent7 (23.3)0 (0)7 (11.7)G110 (33.3)12 (40.0)22 (36.4)G211 (36.7)13 (43.3)24 (40.0)G32 (6.7)5 (16.7)7 (11.7)

Conclusions: the use of argon scalpel, when compared to the electric scalpel, allowed hemostasis to be performed adequately without altering the rates of bleeding, surgical time and postoperative complications, and reduced the number of days with the drain. The thermal effect on the surgical specimen was significant greater with the argon scalpel.

Citation Format: Giordano R, Bromberg S, Elias S, Nazário A, Waitzberg A, Sá R, Facina G. Argon scalpel in the surgical treatment of breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-24.