A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer

Hang Cheng,1 Jeffrey W Clymer,1 Nicole C Ferko,2 Leena Patel,2 Ireena M Soleas,2 Chris G Cameron,2 Piet Hinoul1 1Ethicon Inc., Cincinnati, OH, USA; 2Cornerstone Research Group, Burlington, ON, Canada Background: Mastectomy and breast-conserving surgery (BCS) are important treatment options for breas...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Cheng H, Clymer JW, Ferko NC, Patel L, Soleas IM, Cameron CG, Hinoul P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Mastectomy Breast Conserving Surgery Harmonic technology Meta-Analysis Ultrasonic Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/fe0d411f08e84bffb7fa402a073709a5
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:fe0d411f08e84bffb7fa402a073709a5
record_format	dspace
spelling	oai:doaj.org-article:fe0d411f08e84bffb7fa402a073709a52021-12-02T06:34:56ZA systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer1179-1314https://doaj.org/article/fe0d411f08e84bffb7fa402a073709a52016-07-01T00:00:00Zhttps://www.dovepress.com/a-systematic-review-and-meta-analysis-of-harmonic-technology-compared--peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Hang Cheng,1 Jeffrey W Clymer,1 Nicole C Ferko,2 Leena Patel,2 Ireena M Soleas,2 Chris G Cameron,2 Piet Hinoul1 1Ethicon Inc., Cincinnati, OH, USA; 2Cornerstone Research Group, Burlington, ON, Canada Background: Mastectomy and breast-conserving surgery (BCS) are important treatment options for breast cancer patients. A previous meta-analysis demonstrated that the risk of certain complications can be reduced with the Harmonic technology compared with conventional methods in mastectomy. However, the meta-analysis did not include studies of BCS patients and focused on a subset of surgical complications. The objective of this study was to compare Harmonic technology and conventional techniques for a range of clinical outcomes and complications in both mastectomy and BCS patients, including axillary lymph node dissection.Methods: A comprehensive literature search was performed for randomized controlled trials comparing Harmonic technology and conventional methods in breast cancer surgery. Outcome measures included blood loss, drainage volume, total complications, seroma, necrosis, wound infections, ecchymosis, hematoma, hospital length of stay, and operating time. Risk of bias was analyzed for all studies. Meta-analysis was performed using random-effects models for mean differences of continuous variables and a fixed-effects model for risk ratios of dichotomous variables.Results: Twelve studies met the inclusion criteria. Across surgery types, compared to conventional techniques, Harmonic technology reduced total complications by 52% (P=0.002), seroma by 46% (P<0.0001), necrosis by 49% (P=0.04), postoperative chest wall drainage by 46% (P=0.0005), blood loss by 38% (P=0.0005), and length of stay by 22% (P=0.007). Although benefits generally appeared greatest in mastectomy patients with lymph node dissection, Harmonic technology showed significant reductions in complications in the BCS study subgroup.Conclusion: In this meta-analysis of both mastectomy and BCS procedures, the use of Harmonic technology reduced the risk of most complications by about half across breast cancer surgery patients. These benefits may be due to superior hemostatic capabilities of Harmonic technology and better dissection, particularly lymph node dissection. Reduction in complications and other resource outcomes may engender lower downstream health care costs. Keywords: dissection, complications, ultrasonicCheng HClymer JWFerko NCPatel LSoleas IMCameron CGHinoul PDove Medical PressarticleMastectomyBreast Conserving SurgeryHarmonic technologyMeta-AnalysisUltrasonicNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol 2016, Iss Issue 1, Pp 125-140 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Mastectomy Breast Conserving Surgery Harmonic technology Meta-Analysis Ultrasonic Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Mastectomy Breast Conserving Surgery Harmonic technology Meta-Analysis Ultrasonic Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Cheng H Clymer JW Ferko NC Patel L Soleas IM Cameron CG Hinoul P A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
description	Hang Cheng,1 Jeffrey W Clymer,1 Nicole C Ferko,2 Leena Patel,2 Ireena M Soleas,2 Chris G Cameron,2 Piet Hinoul1 1Ethicon Inc., Cincinnati, OH, USA; 2Cornerstone Research Group, Burlington, ON, Canada Background: Mastectomy and breast-conserving surgery (BCS) are important treatment options for breast cancer patients. A previous meta-analysis demonstrated that the risk of certain complications can be reduced with the Harmonic technology compared with conventional methods in mastectomy. However, the meta-analysis did not include studies of BCS patients and focused on a subset of surgical complications. The objective of this study was to compare Harmonic technology and conventional techniques for a range of clinical outcomes and complications in both mastectomy and BCS patients, including axillary lymph node dissection.Methods: A comprehensive literature search was performed for randomized controlled trials comparing Harmonic technology and conventional methods in breast cancer surgery. Outcome measures included blood loss, drainage volume, total complications, seroma, necrosis, wound infections, ecchymosis, hematoma, hospital length of stay, and operating time. Risk of bias was analyzed for all studies. Meta-analysis was performed using random-effects models for mean differences of continuous variables and a fixed-effects model for risk ratios of dichotomous variables.Results: Twelve studies met the inclusion criteria. Across surgery types, compared to conventional techniques, Harmonic technology reduced total complications by 52% (P=0.002), seroma by 46% (P<0.0001), necrosis by 49% (P=0.04), postoperative chest wall drainage by 46% (P=0.0005), blood loss by 38% (P=0.0005), and length of stay by 22% (P=0.007). Although benefits generally appeared greatest in mastectomy patients with lymph node dissection, Harmonic technology showed significant reductions in complications in the BCS study subgroup.Conclusion: In this meta-analysis of both mastectomy and BCS procedures, the use of Harmonic technology reduced the risk of most complications by about half across breast cancer surgery patients. These benefits may be due to superior hemostatic capabilities of Harmonic technology and better dissection, particularly lymph node dissection. Reduction in complications and other resource outcomes may engender lower downstream health care costs. Keywords: dissection, complications, ultrasonic
format	article
author	Cheng H Clymer JW Ferko NC Patel L Soleas IM Cameron CG Hinoul P
author_facet	Cheng H Clymer JW Ferko NC Patel L Soleas IM Cameron CG Hinoul P
author_sort	Cheng H
title	A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
title_short	A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
title_full	A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
title_fullStr	A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
title_full_unstemmed	A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
title_sort	systematic review and meta-analysis of harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/fe0d411f08e84bffb7fa402a073709a5
work_keys_str_mv	AT chengh asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT clymerjw asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT ferkonc asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT patell asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT soleasim asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT cameroncg asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT hinoulp asystematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT chengh systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT clymerjw systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT ferkonc systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT patell systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT soleasim systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT cameroncg systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer AT hinoulp systematicreviewandmetaanalysisofharmonictechnologycomparedwithconventionaltechniquesinmastectomyandbreastconservingsurgerywithlymphadenectomyforbreastcancer
_version_	1718399852072665088

A systematic review and meta-analysis of Harmonic technology compared with conventional techniques in mastectomy and breast-conserving surgery with lymphadenectomy for breast cancer

Ejemplares similares