Evaluation of operative delays secondary to radiotracer injection in breast cancer surgery
Description
BACKGROUND: Breast cancer is the most prevalent diagnosed malignancy among females in the United States. Current treatment protocols require surgical excision, often involving mastectomy and lymph node biopsy, to evaluate the spread of cancer. This either requires axillary lymph node dissection or sentinel lymph node biopsy utilizing a radiotracer to identify cancer-draining lymph nodes. Debate persists over the safety, efficacy, and efficiency of perioperative injections versus preoperative injections or tracers.
METHODS: We conducted a retrospective analysis of patients who underwent radiotracer injection prior to sentinel lymph node biopsy or targeted lymph node biopsy between November 2021 and July 2023. The radiotracer injection time, OR arrival time, procedure start time, procedure end time, and OR departure time were evaluated to assess the extent of operative delay.
RESULTS: Among 188 procedures analyzed, we found an average delay of 135 minutes in OR arrival time and 163 minutes in scheduled start time. Preoperative radiotracer injection resulted in significantly delayed surgical start times and prolonged procedure initiation.
CONCLUSIONS: Our findings highlighted considerable delays associated with preoperative radiotracer injection. A review of the current literature suggests intraoperative injections are favorable, allowing for better start times, decreased time spent in the operating room, and reduced patient discomfort. Prior research indicated preoperative and intraoperative injections are equally safe, with some suggesting fewer postoperative complications with intraoperative injections. Additionally, intraoperative injections have been associated with reduced hospital costs, decreased workload, and increased OR time for additional procedures.
Evaluation of operative delays secondary to radiotracer injection in breast cancer surgery
Philadelphia, PA
BACKGROUND: Breast cancer is the most prevalent diagnosed malignancy among females in the United States. Current treatment protocols require surgical excision, often involving mastectomy and lymph node biopsy, to evaluate the spread of cancer. This either requires axillary lymph node dissection or sentinel lymph node biopsy utilizing a radiotracer to identify cancer-draining lymph nodes. Debate persists over the safety, efficacy, and efficiency of perioperative injections versus preoperative injections or tracers.
METHODS: We conducted a retrospective analysis of patients who underwent radiotracer injection prior to sentinel lymph node biopsy or targeted lymph node biopsy between November 2021 and July 2023. The radiotracer injection time, OR arrival time, procedure start time, procedure end time, and OR departure time were evaluated to assess the extent of operative delay.
RESULTS: Among 188 procedures analyzed, we found an average delay of 135 minutes in OR arrival time and 163 minutes in scheduled start time. Preoperative radiotracer injection resulted in significantly delayed surgical start times and prolonged procedure initiation.
CONCLUSIONS: Our findings highlighted considerable delays associated with preoperative radiotracer injection. A review of the current literature suggests intraoperative injections are favorable, allowing for better start times, decreased time spent in the operating room, and reduced patient discomfort. Prior research indicated preoperative and intraoperative injections are equally safe, with some suggesting fewer postoperative complications with intraoperative injections. Additionally, intraoperative injections have been associated with reduced hospital costs, decreased workload, and increased OR time for additional procedures.