Surgery: Current Research

ISSN - 2161-1076


Infra Mammary Approach for Major Duct Excision in the Management of Multiple Duct Ectasia: Our First Steps

Ayman Aly Reda ,Tamer M Said *,Sherif Mourad

Objective: Worldwide, classical Hadfield’s operation is recognized as the main surgical procedure for MDE. However, this operation can suffer from certain complications such as the loss of nipple sensation and in some cases skin necrosis and skin loss may take place. This study is aiming to evaluate this new technique (infra mammary approach) for major duct excision as regard operative time and postoperative outcome with especial concern to postoperative complications. Patients and method: Inframammary major duct excision was performed on forty five non-lactating female patients suffering from nipple discharge that was either unilateral or bilateral. Results: The postoperative hospital stay was one day. Suction drain was removed after 4 to 10 days of surgery (mean time 6 days). No seroma or hematomas were observed after removal of the drain. Stitches were removed after 10 to 12 days of surgery after complete healing of the wound. Nipple vitality and sensation were intact in all patients and no color change was recorded. No recurrent discharge was noticed during follow up visits. 95% of patients were satisfied by the result of surgery. Conclusion: Although this was a pilot study that should have been supported by larger number of cases as well as by a comparative study, we can still show that the inframammary approach is superior to the classical approach for major duct excision since it can achieve duct excision while preserving the sensory nerve supply as well as the blood supply of the nipple and areola complex with the normal projection of the nipple and is therefore associated with a higher patients satisfaction.