Estratégias para Prevenção do Seroma em Pacientes Submetidos ao Tratamento Cirúrgico do Câncer de Mama: Revisão Sistemática da Literatura
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n2.4616Palavras-chave:
Neoplasias da Mama/cirurgia, Seroma/prevenção & controle, RevisãoResumo
Introdução: O seroma é a complicação cicatricial mais incidente no pós-operatório do câncer de mama que impacta a qualidade de vida dos pacientes, podendo levar à necessidade de punções repetidas, novos procedimentos cirúrgicos e a atrasos no tratamento adjuvante. Objetivo: Revisão sistemática da literatura científica sobre os procedimentos utilizados para prevenção do seroma em pacientes submetidos ao tratamento cirúrgico do câncer de mama, abordando suas vantagens e desvantagens. Método: Utilizou-se o método da Colaboração Cochrane, sendo incluídos artigos de ensaios clínicos e estudos observacionais. Para identificar estudos relevantes, pesquisaram-se as seguintes bases de dados: MEDLINE via PubMed, PEDro, Cochrane Library e LILACS. A busca foi realizada nos períodos de outubro de 2022 a janeiro de 2023. A qualidade metodológica dos ensaios clínicos foi avaliada pela escala PEDro e a dos estudos observacionais, pela escala de Newcastle-Ottawa. Resultados: Foram identificados 405 artigos e, após avaliação, incluídos 24 para serem analisados. Existem várias abordagens que poderiam minimizar a incidência de seroma, como o uso de dreno, obliteração do espaço morto, os instrumentos utilizados para a dissecação tecidual e as técnicas que poderiam controlar o processo inflamatório. Conclusão: As estratégias de prevenção do seroma utilizadas nos estudos incluídos minimizaram sua incidência, com exceção do talco e do iodo, entretanto, os estudos que tiveram como objetivo a obliteração do espaço morto, seja com sutura quilting ou selante, mostraram resultados estatísticos mais significantes, sugerindo serem promissores para a prevenção do seroma.
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