PhD Scientific Days 2025

Surgical Medicine

Role of perioperative glucocorticoids in the prevention of seroma formation in patients undergoing mastectomies: A systematic review and meta-analysis

Name of the presenter

Doleviczényi Levente

Institute/workplace of the presenter

Semmelweis University Center for Translational Medicine

Authors

Doleviczényi Levente¹, Frivaldszky Lőrinc¹, Rancz Anett¹, Hegyi Péter¹, Klárik Zoltán²

1: Semmelweis University Center for Translational Medicine
2: Semmelweis University Department of Surgery, Transplantation and Gastroenterology

Text of the abstract

Introduction
Breast cancer is one of the most common cancers in women. One of the main complications after mastectomies is seroma formation. Seromas can cause repeated aspiration, pose a risk of infection, and can even lead to the delayment of oncologic treatment. Many strategies have been used for seroma prevention in recent years, but there is no gold standard currently. Our aim is to determine whether perioperative glucocorticoids (GC) are safe and effective for preventing seromas in patients undergoing mastectomies.
Methods
We performed the systematic search in MEDLINE via PubMed, Embase, CENTRAL, Scopus and Web of Science on November 12th, 2024. Eligible studies included women undergoing mastectomies and receiving perioperative glucocorticoids. Risk of bias assessment was performed with the Rob-2 tool for randomized controlled trials (RCT) and the ROBINS-I tool for the case-control study. Results are reported as risk ratios (RR), odds ratios (OR) or mean differences (MDs) with 95% confidence intervals (CIs) and we have presented them as forest plots.
Results
Thirteen studies (12 RCTs and one case-control study) with 1011 patients were included; all were eligible for meta-analysis. Seroma formation rates were significantly lower in the intervention groups (RR = 0,56, CI: 0,38; 0,82, p  0,001). The total volume of drainage (MD = -213,36 ml, CI: -312,5; -114,22, p = 0,001) and days to drain removal (MD = - 3,01 days, CI: -4,06; -1,96, p = 0,001) were also lower in the glucocorticoid groups showing statistical significance. Despite not reaching mathematical significance, wound infection rates showed a higher tendency in the intervention groups (RR = 1,26, CI: 0,82; 1,92, p = 0,224).
Conclusion
Perioperative GC administration is effective in preventing seroma formation in patients undergoing mastectomies, but may elevate wound infection rates.

Funding
Funding was provided by the Centre for Translational Medicine, Semmelweis University. Open-access funding was provided by Semmelweis University. Sponsors had no role in the design, data collection, analysis, interpretation, and manuscript preparation.


E-mail adress: levente.dole@gmail.com
University: Semmelweis University
Supervisor: Dr. Klárik Zoltán PhD

It is preferred to be presented as an oral presentation.