Ultrasonic energy vs electrosurgery in breast cancer surgery: reduction of complications and improving outcome - a retrospective cohort study

Abstract Introduction and objectives Each year, approximately 9500 women in Sweden are diagnosed with breast cancer, majority of them would require surgical treatment. Electrocautery has for a long time been a standard method used by surgeons while in recent years ultrasound energy instruments have been introduced in a larger scale. Aim of the study was to determine whether use of ultrasound energy as method of dissection during breast cancer surgery results in reduction of post-operative complications in form of bleeding, seroma formation and post-operative infections compared to use of electrocautery. Previous studies have indicated a positive effect of ultrasound energy on some postoperative complications, but the results were based on small samples. Therefore, observation of a larger population was warranted. Method Retrospective observational analysis of two cohorts was performed. All women who underwent breast surgery at Södra Älvsborg Hospital during the periods 2016–2017 and 2021–2022 constituted the study population. Until 2018, electrocautery was used for all breast surgeries and after 2020, it was replaced by an ultrasonic instrument. Result In total, 935 patients were included; 397 in the electrocautery cohort and 538 in the ultrasonic cohort. Adjusted for confounders in a logistic regression analysis, a significant difference was observed between both cohorts in regards of all the examined parameters in favor of the group where ultrasound energy instrument was used. Discussion -