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  3. Clinical and cost outcomes of a polyethylene glycol (PEG)-coated patch versus drainage after axillary lymph node dissection in breast cancer: results from a multicentre randomized clinical trial

Clinical and cost outcomes of a polyethylene glycol (PEG)-coated patch versus drainage after axillary lymph node dissection in breast cancer: results from a multicentre randomized clinical trial

Fecha de publicación: Fecha Ahead of Print:

Autores de IDIVAL

  • Jaime Jimeno Fraile

    Autor

Autores ajenos al IDIVAL

  • Buch-Villa E
  • Castañer-Puga C
  • Delgado-Garcia S
  • Fuster-Diana C
  • Vidal-Herrador B
  • Ripoll-Orts F
  • Galeote-Quecedo T
  • Prat A
  • Andrés-Matias M
  • Muñoz-Sorsona E
  • Vento G
  • Gumbau-Puchol V
  • Adrianzen M
  • López-Flor V
  • Ortega J

Abstract

Background The aim of this study was to compare the clinical outcomes between breast cancer patients who underwent axillary lymph node dissection with postoperative management using a polyethylene glycol-coated patch versus axillary drainage. The direct costs associated with both postoperative management strategies were also evaluated. Methods This was a multicentre RCT in women with breast cancer who underwent axillary lymph node dissection (ClinicalTrials.gov identifier: NCT04487561). Patients were randomly assigned (1 : 1) to receive either drainage or a polyethylene glycol-coated patch as postoperative management. The primary endpoints were the need for an emergency department visit for any event related to the surgery and the rate of seroma development. Results A total of 227 patients were included , 115 in the patch group (50.7 per cent) and 112 (29.4 per cent ) in the drainage group. The incidence of emergency department visits was significantly greater for patients with drainage versus a polyethylene glycol-coated patch (incidence rate difference 26.1 per cent, 95 per cent c.i. 14.5 to 37.7 per cent; P < 0.001). Conversely, the seroma rate was significantly higher in the polyethylene glycol-coated patch group (incidence rate difference 22.8 per cent, 95 per cent c.i. 6.7 to 38.9 per cent; P < 0.0055). Compared with drainage, using a polyethylene glycol-coated patch resulted in cost savings of euro100.41 per patient. An incremental cost-effectiveness ratio analysis found that drainage was associated with an incremental cost-effectiveness ratio of euro7594.4 for no need for hospital admission and euro491.7 for no need for an emergency department visit. Conclusion Compared with patients who received drainage after axillary lymph node dissection, the use of a polyethylene glycol-coated patch resulted in a higher rate of seroma, but a lower number of postoperative outpatient or emergency department visits and thus a reduction in overall costs. Although the incidence of seroma was significantly greater in patients who received a polyethylene glycol-coated patch compared with those who received drainage, their postoperative management appeared to be smoother. The use of a polyethylene glycol-coated patch was associated with a lower number of postoperative outpatient visits and a lower number of emergency department visits, which resulted in a reduction in costs

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

Datos de la publicación

ISSN/ISSNe:
0007-1323, 1365-2168

BJS-BRITISH JOURNAL OF SURGERY  BLACKWELL SCIENCE LTD

Tipo:
Article
Páginas:
1180-1188
PubMed:
37311694

Citas Recibidas en Web of Science: 4

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