Ultrasound Guided Needle Aspiration and Cavity Washing Versus Incision and Drainage to Treat The Breast Abscesses—Meta Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGXu-yun ¹ ,  GUOTian-kang ²

1. Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China;
2. The First Department of General Surgery, People's Hospital of Gansu Province, Lanzhou 730000, Gansu Province, China;

Corresponding author：

GUOTian-kang, Email: guotiankangtshui@163.com

Keywords：

Breast abscess; Ultrasound guided; Puncture; Incision and drainage; Meta-analysis

DOI：

10.7507/1007-9424.20160125

Video：

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Objective To evaluate the clinical effect of ultrasound guided puncture irrigation and traditional incision and drainage in the treatment of breast abscess. Methods CNKI, Wanfang Database, CBM, PubMed, Cochrane Library, Web of Science, and EMbase were searched, at the same time complementary with other retrieval in any language to collect the randomized controlled trials (RCTs) about comparison ultrasound guided needle aspiration with incision and drainage to treat the breast abscesses published by late August, 2015. Data related to clinical outcomes were extracted by two reviewers independently. Statistical analyses were carried out using RevMan5.3 software. Results Eight studies were included, which involving 373 participants according to the inclusion criteria. The differences were statistically significant about the cure rate [OR=2.51, 95% CI (1.47, 4.28), P=0.000 8〕, effective rate [OR=7.45, 95% CI (2.29, 24.27), P=0.000 9〕, the heeling time [SMD=-1.77, 95%CI (-2.09, -1.44), P < 0.000 01〕, the length of the scar [MD=-2.88, 95% CI (-3.43, -2.33), P < 0.000 01〕, and the complications [OR=0.18, 95% CI (0.05, 0.62), P=0.007〕. Conciusions Compared with traditional methods of incision and drainage, ultrasound guided needle aspiration and wash has the more cure rate, the more effective rate, the less heeling time and scars as well as complications.

Citation： WANGXu-yun, GUOTian-kang. Ultrasound Guided Needle Aspiration and Cavity Washing Versus Incision and Drainage to Treat The Breast Abscesses—Meta Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 472-477. doi: 10.7507/1007-9424.20160125 Copy

1.	Ulitzsch D, Nyman MKG, Carlson RA. Breast abscess in lactating women:US-guided treatment. Radiology, 2004, 232(3):904-909.
2.	Naeem M, Rahimnajjad MK, Rahimnajjad NA, et al. Comparison of incision and drainage against needle aspiration for the treatment of breast abscess. Am Surg, 2012, 78(11):1224-1227.
3.	吴晓飞, 张弓, 张殿龙, 等.超声引导下穿刺并生理盐水冲洗治疗乳腺脓肿的临床效果观察.中外医疗, 2014, 10:24-25.
4.	Chandika AB, Gakwaya AM, Kiguli-Malwadde E, et al. Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses:a Ugandan experience. BMC Research Notes, 2012, 5:12.
5.	冯安心.超声引导下不停止哺乳穿刺治疗乳腺脓肿的初步临床疗效分析.中国实用药, 2014, 9(35):68-69.
6.	牛冰.超声引导下穿刺冲洗治疗乳腺脓肿的临床效果分析.中国保健营养, 2012, 8(下):2958-2959.
7.	隋世国.乳腺脓肿超声引导穿刺治疗与传统手术治疗临床效果比照观察.中外女性健康研究, 2015, 9:184.
8.	闫长洲.乳腺脓肿超声引导穿刺治疗与传统手术治疗效果对比.医药与保健, 2014, 22(7):53, 100.
9.	赵全平.乳腺脓肿超声引导穿刺治疗与传统手术治疗效果对比.基层医学论坛, 2014, 18(26):3473-3474.
10.	Eryilmaz R, Sahin M, Hakan Tekelioglu M, et al. Management of lactational breast abscesses. Breast, 2005, 14(5):375-379.
11.	Leibman AJ, Misra M, Castaldi M. Breast abscess after nipple piercing sonographic findings with clinical correlation. J Ultrasound, 2011, 30(9):1303-1308.
12.	Berna-Serna JD, Madrigal M, Berna-Serna JD. Percutaneous management of breast abscesses. An experience of 39 cases. Ultrasound Med Biol, 2004, 30(1):1-6.
13.	Amir LH, Forster D, McLachlan H, et al. Incidence of breast abscess in lactating women:report from an Australian cohort. BJOG, 2004, 111(12):1378-1381.
14.	Benson EA. Management of breast abscesses. World J Surg, 1989, 13(6):753-756.
15.	Battle RJ, Bailey GN. The treatment of acute intramammary abscess by incision and aspiration. Br J Surg, 1923, 10:436-441.
16.	Florey ME, Macvine JS, Rigby MA. Treatment of breast abscesses with penicillin. Br Med J, 1946, 2(4483):845-848.
17.	Leborgne F, Leborgne F. Treatment of breast abscesses with sonographically guided aspiration, irrigation, and instillation of antibiotics. AJR Am J Roentgenol, 2003, 181(4):1089-1091.
18.	Karstrup S, Nolsoe C, Brabrand K, et al. Ultrasonically Guided Percutaneous Drainage of Breast Abscesses. Acta Radiol, 1990, 31(2):157-159.
19.	Karstrup S, Solvig J, Nolsoe C, et al. Acute Puerperal breast abscesses:US-guided drainage. Radiology, 1993, 188(3):807-809.
20.	Fahrni M, Schwarz EI, Stadlmann S, et al. Breast abscesses:diagnosis, treatment and outcome. Breast Care (Basel), 2012, 7(1):32-38.
21.	Sun HD, Teng SW, Huang BS, et al. Combination of ultrasound-guided drainage and antibiotics therapy provides a cosmetic advantage for women with methicillin-resistant Staphylococcus aureus breast abscess. Taiwan J Obstet Gynecol, 2014, 53(1):115-117.
22.	Prasad SN, Houserkova D. A comparison of mammography and ultrasonography in the evaluation of breast masses. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2007, 151(2):315-322.
23.	Chick JF, Chauhan NR, Polen LA. Emergency management of puerperal breast abscess. Intern Emerg Med, 2012, 7 (Suppl 2):S167-S168.
24.	Kataria K, Srivastava A, Dhar A. Management of lactational mastitis and breast abscesses:review of current knowledge and practice. Indian J Surg, 2013, 75(6):430-435.
25.	Shaikh B, Ali Shah A, Muhammad Sohu K, et al. Needle aspiration in the treatment of breast abscess. Rawal Med J, 2014, 39(1):58-60.
26.	Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg, 2001, 182(2):117-119.
27.	Scott BG, Silberfein EJ, Pham HQ, et al. Rate of malignancies in breast abscesses and argument for ultrasound drainage. Am J Surg, 2006, 192(6):869-872.
28.	Strauss A, Middendorf K, Muller-Egloff S. et al. Sonographically guided percutaneous needle aspiration of breast abscesses-a minimal-invasive alternative to surgical incision. Ultraschall Med, 2003, 24(6):393-398.
29.	Ozseker B, Ozcan UA, Rasa K, et al. Treatment of breast abscesses with ultrasound-guided aspiration and irrigation in the emergency setting. Emerg Radiol, 2008, 15(2):105-108.
30.	Hook GW, Ikeda DM. Treatment of breast abscesses with US-guided percutaneous needle drainage without indwelling catheter placement. Radiology, 1999, 213(2):579-582.
31.	Irusen H, Rohwer AC, Steyn DW, et al. Treatments for breast abscesses in breastfeeding women. Cochrane Database Syst Rev, 2015, 8:CD010490.
32.	Blaivas M. Ultrasound-guided breast abscess aspiration in a difficult case. Acad Emerg Med, 2001, 8(4):398-401.
33.	Christensen AF, Al-Suliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses:results in 151 patients. Br J Radiol, 2005, 78(927):186-188.
34.	Kjaer S, Rud B, Bay-Nielsen M. Ultrasound-guided drainage of subcutaneous abscesses on the trunk is feasible. Dan Med J, 2013, 60(4):A4601.
35.	Berná-Serna JD, Berná-Mestre JD, Galindo PJ, et al. Use of urokinase in percutaneous drainage of large breast abscesses. J Ultrasound Med, 2009, 28(4):449-454.
36.	Dener C, Inan A. Breast abscesses in lactating women. World J Surg, 2003, 27(2):130-133.
37.	Elagili F, Abdullah N, Fong L, et al. Aspiration of breast abscess under ultrasound guidance:outcome obtained and factors affecting success. Asian J Surg, 2007, 30(1):40-44.

1. Ulitzsch D, Nyman MKG, Carlson RA. Breast abscess in lactating women:US-guided treatment. Radiology, 2004, 232(3):904-909.
2. Naeem M, Rahimnajjad MK, Rahimnajjad NA, et al. Comparison of incision and drainage against needle aspiration for the treatment of breast abscess. Am Surg, 2012, 78(11):1224-1227.
3. 吴晓飞, 张弓, 张殿龙, 等.超声引导下穿刺并生理盐水冲洗治疗乳腺脓肿的临床效果观察.中外医疗, 2014, 10:24-25.
4. Chandika AB, Gakwaya AM, Kiguli-Malwadde E, et al. Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses:a Ugandan experience. BMC Research Notes, 2012, 5:12.
5. 冯安心.超声引导下不停止哺乳穿刺治疗乳腺脓肿的初步临床疗效分析.中国实用药, 2014, 9(35):68-69.
6. 牛冰.超声引导下穿刺冲洗治疗乳腺脓肿的临床效果分析.中国保健营养, 2012, 8(下):2958-2959.
7. 隋世国.乳腺脓肿超声引导穿刺治疗与传统手术治疗临床效果比照观察.中外女性健康研究, 2015, 9:184.
8. 闫长洲.乳腺脓肿超声引导穿刺治疗与传统手术治疗效果对比.医药与保健, 2014, 22(7):53, 100.
9. 赵全平.乳腺脓肿超声引导穿刺治疗与传统手术治疗效果对比.基层医学论坛, 2014, 18(26):3473-3474.
10. Eryilmaz R, Sahin M, Hakan Tekelioglu M, et al. Management of lactational breast abscesses. Breast, 2005, 14(5):375-379.
11. Leibman AJ, Misra M, Castaldi M. Breast abscess after nipple piercing sonographic findings with clinical correlation. J Ultrasound, 2011, 30(9):1303-1308.
12. Berna-Serna JD, Madrigal M, Berna-Serna JD. Percutaneous management of breast abscesses. An experience of 39 cases. Ultrasound Med Biol, 2004, 30(1):1-6.
13. Amir LH, Forster D, McLachlan H, et al. Incidence of breast abscess in lactating women:report from an Australian cohort. BJOG, 2004, 111(12):1378-1381.
14. Benson EA. Management of breast abscesses. World J Surg, 1989, 13(6):753-756.
15. Battle RJ, Bailey GN. The treatment of acute intramammary abscess by incision and aspiration. Br J Surg, 1923, 10:436-441.
16. Florey ME, Macvine JS, Rigby MA. Treatment of breast abscesses with penicillin. Br Med J, 1946, 2(4483):845-848.
17. Leborgne F, Leborgne F. Treatment of breast abscesses with sonographically guided aspiration, irrigation, and instillation of antibiotics. AJR Am J Roentgenol, 2003, 181(4):1089-1091.
18. Karstrup S, Nolsoe C, Brabrand K, et al. Ultrasonically Guided Percutaneous Drainage of Breast Abscesses. Acta Radiol, 1990, 31(2):157-159.
19. Karstrup S, Solvig J, Nolsoe C, et al. Acute Puerperal breast abscesses:US-guided drainage. Radiology, 1993, 188(3):807-809.
20. Fahrni M, Schwarz EI, Stadlmann S, et al. Breast abscesses:diagnosis, treatment and outcome. Breast Care (Basel), 2012, 7(1):32-38.
21. Sun HD, Teng SW, Huang BS, et al. Combination of ultrasound-guided drainage and antibiotics therapy provides a cosmetic advantage for women with methicillin-resistant Staphylococcus aureus breast abscess. Taiwan J Obstet Gynecol, 2014, 53(1):115-117.
22. Prasad SN, Houserkova D. A comparison of mammography and ultrasonography in the evaluation of breast masses. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2007, 151(2):315-322.
23. Chick JF, Chauhan NR, Polen LA. Emergency management of puerperal breast abscess. Intern Emerg Med, 2012, 7 (Suppl 2):S167-S168.
24. Kataria K, Srivastava A, Dhar A. Management of lactational mastitis and breast abscesses:review of current knowledge and practice. Indian J Surg, 2013, 75(6):430-435.
25. Shaikh B, Ali Shah A, Muhammad Sohu K, et al. Needle aspiration in the treatment of breast abscess. Rawal Med J, 2014, 39(1):58-60.
26. Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg, 2001, 182(2):117-119.
27. Scott BG, Silberfein EJ, Pham HQ, et al. Rate of malignancies in breast abscesses and argument for ultrasound drainage. Am J Surg, 2006, 192(6):869-872.
28. Strauss A, Middendorf K, Muller-Egloff S. et al. Sonographically guided percutaneous needle aspiration of breast abscesses-a minimal-invasive alternative to surgical incision. Ultraschall Med, 2003, 24(6):393-398.
29. Ozseker B, Ozcan UA, Rasa K, et al. Treatment of breast abscesses with ultrasound-guided aspiration and irrigation in the emergency setting. Emerg Radiol, 2008, 15(2):105-108.
30. Hook GW, Ikeda DM. Treatment of breast abscesses with US-guided percutaneous needle drainage without indwelling catheter placement. Radiology, 1999, 213(2):579-582.
31. Irusen H, Rohwer AC, Steyn DW, et al. Treatments for breast abscesses in breastfeeding women. Cochrane Database Syst Rev, 2015, 8:CD010490.
32. Blaivas M. Ultrasound-guided breast abscess aspiration in a difficult case. Acad Emerg Med, 2001, 8(4):398-401.
33. Christensen AF, Al-Suliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses:results in 151 patients. Br J Radiol, 2005, 78(927):186-188.
34. Kjaer S, Rud B, Bay-Nielsen M. Ultrasound-guided drainage of subcutaneous abscesses on the trunk is feasible. Dan Med J, 2013, 60(4):A4601.
35. Berná-Serna JD, Berná-Mestre JD, Galindo PJ, et al. Use of urokinase in percutaneous drainage of large breast abscesses. J Ultrasound Med, 2009, 28(4):449-454.
36. Dener C, Inan A. Breast abscesses in lactating women. World J Surg, 2003, 27(2):130-133.
37. Elagili F, Abdullah N, Fong L, et al. Aspiration of breast abscess under ultrasound guidance:outcome obtained and factors affecting success. Asian J Surg, 2007, 30(1):40-44.

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Ultrasound Guided Needle Aspiration and Cavity Washing Versus Incision and Drainage to Treat The Breast Abscesses—Meta Analysis

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