A Systematic Review and Meta-analysis of Harmonic Technology Compared With Conventional Techniques in Mastectomy and Breast-conserving Surgery With Lymphadenectomy for Breast Cancer

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Postoperative drainage volume of the chest wall

In contrast to conventional methods in breast surgery, mean postoperative drainage volume of the chest wall (Harmonic technology: 49.96 mL, conventional technique: 92.06 mL) was statistically significantly reduced by 42.14 mL (95% CI: −65.90 to −18.39; P=0.0005; four studies; I²=87%) with the Harmonic scalpel (Figure 4; Table 3). This translates to a 45.77% decrease with Harmonic technology compared to conventional techniques in breast surgery. Reductions in postoperative drainage volume of the chest wall were statistically significant across all study subgroups, with the greatest reductions observed in studies focusing on mastectomies.

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Postoperative hospital length of stay

Mean postoperative hospital length of stay (Harmonic technology: 4.78 days, conventional techniques: 6.15 days) was statistically significantly reduced by 1.38 days (95% CI: −2.38 to −0.38; P=0.007; four studies; I²=98%) with Harmonic technology, a 22.44% decrease with Harmonic technology compared to conventional techniques in breast surgery (Figure 5; Table 3). A subgroup analysis for studies including mastectomy (and excluding BCS) was not conducted due to limited data.

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