Abstract
ROLE OF AGNI- KARMA (ELECTRO SURGICAL CAUTERIZATION) IN BREAST CANCER–STAGE-I (T1N0M0) AS A APUNARBHAVA CHIKITSA (NO RECURRENCE): A CLINICAL REVIEW STUDY

*Dr. Maheshkumar Nilkanth Chaudhari and Dr. Nilesh Chandak

ABSTRACT

Purpose: The aim of this study is - to evaluate the effect of Agni-karma (Electro surgical cauterization) in Breast cancer surgery –Stage – I (T1N0M0) as a Apunarbhava chikitsa (No recurrence). Carcinoma of the breast is the leading cause of cancer deaths in females in the India. 60 consecutive Stage -I breast cancer (T1N0M0) patients taken for modified radical mastectomy were evaluated prospectively. Electro surgical cautery (i.e. Group-A) was used in 30 MRM operations and no electro surgical cautery was used in another 30 MRM operations (i.e. Group-B) in random order. In the first 30 patients (Group-A)- electro surgical cautery dissection was used to develop the thin skin flaps, MRM & axilla clearance. In the second group of 30 patients (Group-B), sharp dissection by scalpel was used for thin flap elevation, MRM & axilla clearance. In the post operative period vaccum drainage amount, duration & surgery time as well as the start time of arm exercise & long term followup for non –recurrence & metastasis were recorded. Complications like seroma, surgical site infection, haematoma & flap necrosis were determined without following of chemo & radiation therapy the recurrence rate & development of metastasis were also determined for next 5 years. Age, body mass index, breast volume & other parameters were similar in each group. Blood loss during this procedure is frequently high, often necessitating transfusion. Unfortunately, complications of this surgery have been significant. In this study, blood loss and wound healing with and without the use of electrocautery, in radical mastectomy were evaluated from both clinical and laboratory studies. The average blood replacement for Group-A was 160 ml per patient when cautery was used vs. 560 ml per patient when cautery was not used (Group-B). The postoperative hemoglobin and hematocrit values were statistically similar for both groups. Age - mean – 55 yr. & 53 yr. in Group-A & Group-B respectively. Vaccum drainage mean- 557ml & 840 ml in Group-A & Group-B respectively. Duration of surgical time decreased in Group –A by more than 30% to Group-B. Formation of seroma in Group-A is more than Group-B. Recurrence of disease / metastasis is nil & found 4 patients in follow-up of post operative 5 years in Group-A & Group-B resp. Average blood loss 160 ml & 560 ml in Group-A & Group-B resp. There was no statistical significance between the groups regarding time to start arm exercise, surgical site infection and flap necrosis were considered. Electro-Surgical Cautery is a new surgical instrument which provide atraumatic, scalpel like cutting incision, haemostasis, minimal tissue injury, so electro surgical cautery shortens the drainage amount, blood loss & duration of time compared to classical MRM operation of by scalpel method. As there is Agni- karma so there is less chances of recurrence or metastasis of disease too.

Keywords: Breast neoplasm, electrosurgical cautery & Agni-karma, classical scalpel method, complication, recurrence or metastasis.


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