Study the role of octreotide in the management of post mastectomy lymphorrhea

Srilaxmi, Murugan (2018) Study the role of octreotide in the management of post mastectomy lymphorrhea. Masters thesis, Stanley Medical College, Chennai.


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BACKGROUND: Axillary lymph node dissection is an integral part of modified radical mastectomy which is the prime modality of treatment for curable breast cancer. Post mastectomy lymphorrhoea is a disabling morbidity with no definite cure in the horizon. Octreotide is a synthetic somatostatin analogue with general antisecretory effects that is used to control lymphorrhea in thoracic duct injury and after radical neck dissection AIM OF THE STUDY: The aim of the study is to find if octreotide has a role in the treatment of post axillary lymphadenectomy lymphorrhea. Place of Study: Government Stanley Medical College Hospital. Duration: November 2016 to September 2017. Study Design: This is a prospective randomized controlled trial. Number of subjects: 50. Randomly allotted to Treatment group 25, Control group 25. INCLUSION CRITERIA: All female patients diagnosed to have carcinoma breast within the age group of 30yrs to 80yrs who underwent modified radicle mastectomy were included EXCLUSION CRITERIA: Patients with the following comorbidities were excluded: 1. Diabetes, 2. Hepatobiliary disease, 3. Thyroid disorders, 4. Cardiac diseases, 5. Pancreatitis, 6. Patients with allergy to octreotide. METHOLOGY: The treatment group received0.1 mg octreotide subcutaneously thrice daily for 5 consecutive days, starting on the first postoperative day. The control group did not receive any treatment. The fluid in the axillary suction drain (secured in the intra op period) is measured in milliliters from post operative day 1, for 10 consecutive days for both the treatment and control groups. If there was > 30ml collection in the drain for three successive days then the drain was removed before the tenth day. The day of removal of the drain was also taken in to consideration. The fluid was confirmed to be lymph through biochemical tests. The control group and the treatment group were evaluated for amount and duration of lymphorrhea. ANALYSIS: Mean quantity and duration of lymphorrhea in control and treatment group are compared. SIMILAR STUDY: A prospective randomised controlled trail done by paolo carcoforo et al. followed 261 patients with various stages of breast cancer who underwent axillary dissection for seven years of these 136 was taken as control group and 125 as treatment group.The treatment group was given 0.1 mg octreotide subcutaneous for thrice daily for 5 days. CONCLUSION: From this study it is evident that octreotide and its analogues have a promising role in the treatment of post mastectomy lymphorrea. Since lymphorrhoea leads to chronic lymphoedema which inturn predisposes to lymphangiosarcoma, it is safe to assume that the use of octreotide also reduces the risk of incidence of this malignancy. similarly octreotide can also be tried in other conditions were lymphorrhoea is troublesome like in inguinal lymph node dissection, peripheral vascular surgery. Though octreotide is a promising drug several more clinical trails have to be undertaken before bringing it into mainstream practice for better understanding of the drug’s pharmacodynamics and its rare but serious side effects.

Item Type: Thesis (Masters)
Additional Information: REG NO: 221511071
Uncontrolled Keywords: octreotide ; management ; post mastectomy lymphorrhea.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 05 Aug 2018 14:35
Last Modified: 05 Aug 2018 14:35

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