Comparison of Outcome with Ultrasonic Dissector Versus Electrocautery in Modified Radical Mastectomy

Ultrasonic Dissector vs Electrocautery in MRM Outcomes

Abstract

Breast cancer is the most diagnosed cancer globally. Breast-conservative surgeries are done in several ways to treat non-metastatic breast cancer. Objectives: To compare the duration of surgery, duration of drains, and incidence of seroma formation between bipolar electrocautery and ultrasonic dissector in patients undergoing modified radical mastectomy (MRM) for breast cancer. Methods: This randomized controlled trial was conducted at the Department of Surgery in Bahawal Victoria Hospital, Bahawalpur, from June to December 2024. A total of 138 women aged 35 to 65 years with operable breast cancer planned for MRM were enrolled and randomized into two groups: bipolar electrocautery and ultrasonic dissector. The primary outcome was the incidence of seroma formation, and the secondary outcomes were duration of surgery and drain placement. Data were analyzed using SPSS version 23.0 with an independent sample t-test and chi-square test / Fisher’s exact test applied where appropriate. A p-value<0.05 was considered statistically significant. Results: Patients had a mean age of 50.5±7.8 years; 52.2% of the patients were obese. Both groups were comparable at baseline. The mean operative time and drain duration were significantly lower in the ultrasonic dissector group (41.5 ± 4.4 min and 4.0 ± 0.8 days) compared to the electrocautery group (52.9 ± 4.2 min and 7.1 ± 1.2 days) (p<0.001). Seroma formation occurred in 10.1% cases and was significantly less frequent in the ultrasonic group (14.3% vs. 85.7%, p=0.009). Conclusions: Ultrasonic dissector significantly reduced operative time, drain duration, and seroma formation compared to electrocautery in patients undergoing MRM.