Comparative Outcomes of Different Surgical Approaches for Non-Lactational Mastitis With Posterior and Non-Posterior Space Abscesses: A Retrospective Cohort Study

不同手术方法治疗非哺乳期乳腺炎(伴后间隙及非后间隙脓肿)的疗效比较:一项回顾性队列研究

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Abstract

OBJECTIVE: This study aims to compare the outcomes of different surgical approaches for treating non-lactational mastitis, with a particular focus on the differences between posterior and non-posterior space abscesses. It evaluates the effectiveness of Postoperative Vacuum Drainage (POVD) in enhancing recovery and alleviating pain compared to traditional methods. METHODS: A retrospective analysis was conducted on 98 female patients diagnosed with non-lactational mastitis at the Third People's Hospital of Chengdu between March 2014 and December 2020. Patients were classified into posterior space abscess (n = 40) and non-posterior space abscess (n = 58) groups. Clinical data, treatment modalities, and outcomes were compared. Statistical analyses included the Independent t-test for continuous variables and the chi-square test for categorical variables, with significance set at p < 0.05. RESULTS: Patients with posterior space abscesses exhibited higher preoperative Visual Analog Scale (VAS) scores (7 [IQR: 5-8] and 5 [IQR: 3-6], p < 0.05) and more severe pain. Their complete response time was also longer (6.0 vs. 5.0 months, p < 0.05). The use of incision and drainage decreased by 69.4%, while percutaneous aspiration increased annually. For posterior space abscesses, combined operations (incision, drainage, and POVD) significantly shortened response time, reduced the number of punctures, and improved postoperative VAS scores compared to percutaneous aspiration alone (p < 0.05). CONCLUSION: Posterior space abscesses were associated with more severe symptoms and prolonged healing. Combined treatments incorporating POVD demonstrated superior effectiveness over single percutaneous aspiration. POVD is highlighted as a promising, minimally invasive, and cost-effective solution for managing non-lactational mastitis with posterior space abscesses.

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