ROLE OF MINI-INVASIVE SURGERY IN TREATMENT OF LACTATION MASTITIS
https://doi.org/10.38181/2223-2427-2021-2-25-31
Abstract
Introduction. Lactation mastitis is not a rear pathology. It is observed at every tenth parturient woman, mainly in the case of premature termination of breastfeeding. When analyzing the structure of postpartum purulent-inflammatory complications, most researchers report about high frequency lactational mastitis (in 26-67% cases). The technique of conducting wide incisions to drain the breast abscess and drug cessation of lactation was adopted to treat lactational abscess.
Purpose. Specify the location for minimally invasive surgical techniques (puncture and drainage of the nidus of infection under ultrasound guidance) in the complex treatment of lactational abscesses of the mammary glands.
Materials and methods. 64 parturient women suffering from verified lactation abscesses were observed. Average age of patients was 24,9±4,5 years (from 21 to 44). The research was carried out during 3 years: from 2018 to 2020. All patients were on outpatient treatment and under observation. Conservative and surgical (minimally invasive) methods of breast abscess treatment were applied. Puncture of the lactation abscess was carried out with a thick needle (18g «pink»), at the greatest distance from the areola, after expressing / feeding.
Results. 41% of breast abscesses occurred during lactation up to 1 month, while in 34% of cases, the period of lactation was in the range from 1 to 3 months. In 16% of patients, an abscess formed during lactation from 3 to 7 months, in 7% of cases - from 7 to 18 months. Duration of breastfeeding was investigated at the 3rd day, 3rd week and 12th week after surgery. Breastfeeding was interrupted on women’s request. As a result we found out, that minimally invasive (puncture, drainage) surgical methods for treating breast abscesses should be prioritized at complex treatment programs for lactational mastitis.
About the Authors
O. I. Yakovenko
North-Western State Medical University named after I.I.Mechnikov
Russian Federation
Russian Federation
PhD, assistant of the Department of Surgery named after N. D. Monastyrsky
191015, St. Petersburg, Kirochnaya St., 41
T. V. Yakovenko
North-Western State Medical University named after I.I.Mechnikov
Russian Federation
Russian Federation
PhD, associate Professor of the Department of Hospital Surgery
191015, St. Petersburg, Kirochnaya St., 41
V. P. Akimov
North-Western State Medical University named after I.I.Mechnikov
Russian Federation
Russian Federation
Dr. Sci., Prof., Head of the Department of Surgery named after N. D. Monastyrsky
191015, St. Petersburg, Kirochnaya St., 41
A. N. Tkachenko
North-Western State Medical University named after I.I.Mechnikov
Russian Federation
Russian Federation
Dr. Sci., Professor of the Department of Traumatology and Orthopedics
191015, St. Petersburg, Kirochnaya St., 41
References
1. Andreeva I.V., Golicheva I.N. Experience in the treatment of acute purulent lactational mastitis. Al'manah instituta hirurgii im. A.V.Vishnevskogo = Almanac of the Institute of 30 Хирургическая №2 (44), 2021 практика Surgery named after A.V.Vishnevsky. 2020, №1. 816-817. (In Russian.)
2. Jahanfar Sh. Jenn Ng Ch., Teng Ch.L. Antibiotics for mastitis in breastfeeding women, Sao Paulo Med J. 2016, 134 (3). 1375-1377. https://doi.org/10.1590/1516-3180.20161343T1
3. Alekseev S.A., Popkov O.V., Ginyuk V.A., Koshevsky P.P. Acute purulent lactation mastitis and features of its surgical treatment. Voennaja medicina = Military medicine. 2018. No. 4 (49). pp. 93-98. (In Russian.)
4. Gusejnov A.Z. Acute lactation mastitis. Klinicheskaya medicina i farmakologiya = Clinical medicine and pharmacology. 2015. 1 (2). - 11-22. (In Russian.)
5. Liu YY, Chen WC, Chen SL. The Continued Breastfeeding Experiences of Women Who Suffer From Breast Abscess. Hu Li Za Zhi. 2016 Apr;63(2):49-57. Chinese. https://doi.org/10.6224/JN.63.2.49
6. Ryumina I.I., Levadnaya A.V., Zubkov V.V Lactostasis and prevention of lactational mastitis: the role of the neonatologist and pediatrician. Medicinskij sovet = Medical advice. 2020, № 1. 170-175. (In Russian.)
7. Spencer J.P. Management of mastitis in breastfeeding women. Am Fam Physician. 2008. 78(6). 727-731.
8. Petryanik N.N. Lactational mastitis. Conservative treatment issues. Nauchnyj vestnik zdravoohraneniya Kubani = Scientific bulletin of health care of the Kuban. 2015. № 5. 64-89. (In Russian.)
9. Bahovadinova SH.B., Dzidzava I.I., Kovalenko N.A., Ioncev V.I. Minimally invasive treatment of acute purulent lactational mastitis. Infekcii v hirurgii = Infections in surgery. 2018. 16 (1-2). 76-77. (In Russian.)
10. Pustotina O.A. Experience in the treatment of lactation mastitis in 642 maternity hospitals in Russia. Comparative analysis with international recommendations. Arhiv Akusherstva i ginekologii im. V.F.Snegireva = Archive of Obstetrics and Gynecology named after V.F.Snegirev 2015. № 2. 42-47. (In Russian.)
11. Chen C. Luo L.-B, Gao D., Qu B., Guo Y.-M., Huo J.-L., Su Y.-Y. Surgical drainage of lactational breast abscess with ultrasound-guided Encor vacuum-assisted breast biopsy system. Breast J. 2019. Sep;25(5):889-897. https://doi.org/10.1111/tbj.13350
12. Luo J., Long T., Cai Y., Teng Y., Fan Z., Liang Z., Zhu C., Ma H., Li G. Abscess drainage with or without antibiotics in lactational breast abscess: study protocol for a randomized controlled trial. Infect Drug resist. 2020; №13; 183 – 190. https://doi.org/10.2147/IDR.S221037
Review
For citations:
Yakovenko O.I., Yakovenko T.V., Akimov V.P., Tkachenko A.N. ROLE OF MINI-INVASIVE SURGERY IN TREATMENT OF LACTATION MASTITIS. Surgical practice (Russia). 2021;(2):25-31. (In Russ.) https://doi.org/10.38181/2223-2427-2021-2-25-31
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