ArticleAesthetic plastic surgery2026
Side-Specific 24 h Pre-Removal Drainage Volume and Fluid-Related Complications After Endoscopic Gynecomastia Surgery.
Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundDrain removal after transaxillary single-port endoscopic surgery for gynecomastia remains experience-based, and side-specific drainage thresholds are lacking.
methodsThis retrospective cohort study used operated sides as analytic units. Eligible sides had independent negative-pressure drainage and complete follow-up. Exposure was side-specific 24 h drainage volume before removal. Outcome was ultrasonographically confirmed and aspiration-verified seroma or hematoma within 14 days. Discrimination was assessed by receiver operating characteristic analysis with clustered bootstrap confidence intervals, clustered bootstrap cutoff-stability analysis, and likelihood ratios. Associations were evaluated using generalized estimating equation logistic regression with temporal, surgery-type, laterality, intracluster correlation, and effective-information-size sensitivity analyses.
resultsAmong 88 patients and 160 operated sides, 32 sides (20.0%) developed fluid-related complications. The area under the receiver operating characteristic curve was 0.729 (95% CI, 0.635-0.815). The raw cutoff was 13.5 mL; 15 mL was selected as the exploratory threshold. At 15 mL, sensitivity was 65.6%, specificity 63.3%, positive predictive value 30.9%, negative predictive value 88.0%, positive likelihood ratio 1.79, and negative likelihood ratio 0.54. Complication rates were 30.9% (21/68) for at least 15 mL and 12.0% (11/92) for less than 15 mL. After adjustment, at least 15 mL remained associated with increased risk (odds ratio [OR], 3.09; 95% CI, 1.28-7.47). Additional temporal and surgery-type/laterality sensitivity analyses were directionally consistent but imprecise, supporting exploratory interpretation.
conclusionsSide-specific 24 h drainage volume before removal was associated with fluid-related complications. The 15 mL threshold may help identify lower-risk sides in this cohort, but predictive values are prevalence-dependent and the threshold should be interpreted as an exploratory, overall risk-stratification reference rather than a POD-specific or mandatory drain-removal rule. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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