[Second-look operations in malignancies of the breast]. / Second look operacije kod malignoma dojke.

Second look operation in surgical oncology practice has been performed because of three reasons: 1. revision of operative wound due to hematoma and dehiscence of wound, 2. doubt on local recidive and 3. because of doubt on spreading process on second breast. During the period from 1977 to 1986 at surgical oncology we had revision due to hematoma and dehiscence-27, local recidives-147, metastasis in lymphoglads axilla neck, parasternal and subclavicular-38. Metastasis in second breast were 11. Up to local recidive and expansion on a second breast we have got a period of relatively good health. At reoperation because of dehiscence and hematoma interval between two operation is very short so we have got present not only hypovolemia but also summation effect of used anesthetic and plasma expander. In our material, except anesthesia a great influence on blood hemism has got irradiation and cytostatic therapy so out of 147 women patients-45 have been previously radiated, 4 under cytostatic therapy, while combined therapy had 31 patients. And that was the reason why we had to examine the influence of anesthesia polyhemio and irradiation therapy on a change in hepatogramms, blood picture and coagulation. Found deviation are statistically significant in proportion, so we emphasize it a fact, that at revision we can't find very often the source of bleeding, connected with disorders of coagulation which we have found in our examination. Because of that, without regard on a spreading hematoma, we suggest parallel hemism, and before closing the wound local use of Beriplast or Surgicel.