Comparison of Axillary Drain Output After Level 2 Dissection Using Monopolar Electrocautery Versus LigaSure

Background: Conventional monopolar electrocautery in level-II axillary lymph-node dissection is associated with seroma formation and thermal injury. LigaSure, an electrothermal bipolar vessel-sealing system, may reduce postoperative drainage. The study aimed to compare axillary drain output after level II dissection using electrocautery vs. Ligasure. Methods: In this quasi-experimental study, 60 women with breast cancer undergoing level-II axillary lymph node dissection at Allied Hospital, Faisalabad, were allocated to monopolar electrocautery (Group A) or LigaSure (Group B) from 1st October 2023 to 30th March 2024. A non-probability consecutive sampling technique was used. Axillary drain output was the primary endpoint. Age, body mass index, duration of surgery, number of nodes removed, diabetes, hypertension, residence, radiotherapy, and chemotherapy status were recorded. Data were analyzed in SPSS v25.0. Quantitative variables were expressed as mean ± SD; categorical variables as frequency (%). Mean drain output between groups was compared with an independent-samples t-test, and p≤ 0.05 was considered significant. Results: Mean age was 52.2 ± 7.2 years in Group A and 49.1 ± 7.1 years in Group B; mean BMI was 28.9 ± 2.4 kg/m². Average surgery time was 78.8 ± 7.5 min with 3.4 ± 0.9 nodes excised. Group A showed significantly higher drain output (290.0 ± 40.0 mL) than Group B (164.6 ± 18.0 mL); mean difference = −125.4 mL (p < 0.001). Conclusion: LigaSure markedly reduces postoperative axillary drainage compared with monopolar electrocautery during level-II ALND, supporting its routine use to minimize seroma risk in breast-cancer surgery.