【摘要】 目的 探討乳腺癌保乳切除加經(jīng)乳腔鏡清掃腋窩淋巴結(jié)的可行性和手術(shù)難點。 方法 將2007年2月－2011年2月行乳腺癌保乳切除手術(shù)的27例患者，分成乳腔鏡腋窩清掃組（乳腔鏡組）11例和常規(guī)腋窩清掃組（常規(guī)組）16例，比較兩組患者手術(shù)時間、術(shù)中出血量、術(shù)中清掃淋巴結(jié)數(shù)、術(shù)后引流時間及引流量等。 結(jié)果 手術(shù)時間:乳腔鏡組（186.36±11.20） min，常規(guī)組（158.13±25.29） min，兩組差異有統(tǒng)計學(xué)意義（P=0.002）；術(shù)中出血量:乳腔鏡組（61.82±51.54） mL，常規(guī)組（103.75±42.56） mL，兩組差異有統(tǒng)計學(xué)意義（P=0.030）；兩組術(shù)中清掃淋巴結(jié)個數(shù)、術(shù)后引流時間、引流量比較，差異均無統(tǒng)計學(xué)意義（P gt;0.05）；隨訪1個月~4年，無一例發(fā)生腫瘤局部復(fù)發(fā)或戳孔轉(zhuǎn)移。 結(jié)論 乳腺保乳切除加經(jīng)乳腔鏡清掃腋窩淋巴結(jié)可以安全應(yīng)用于早期乳癌的保乳治療，操作者需學(xué)習(xí)一定的手術(shù)技巧。
【Abstract】 Objective To investigate the feasibility and surgical difficulty of breast-conserving resection and endoscopy-assisted axillary lymph node dissection for breast cancer patients. Methods Twenty-seven patients treated by breast-conserving surgery from February 2007 to February 2011 in our hospital were divided into endoscopy-assisted axillary lymph node dissection group (the EALND group, n=11) and conventional axillary lymph node dissection group (the CALND group, n=16). Then, we compared the operation time, intra-operative bleeding volume, number of lymph nodes dissected, postoperative drainage time and amount between the two groups. Results The operation time was significantly longer in the EALND group than that in the CALND group [(186.36±11.20) vs. (158.13±25.29) minutes, P=0.002]. The intra-operative bleeding volume of the EALND group was significantly less than that of the CALND group [(61.82±51.54) vs. (103.75±42.56) mL, P=0.030]. There were no significant differences between the two groups in the number of lymph nodes dissected, postoperative drainage time and amount. Follow-up was done for one month to four years, during which no local recurrence or trocar displacing occurred. Conclusion The breast-conserving resection and endoscopy-assisted axillary lymph node dissection can be safely used in early breast cancer patients, and surgical skills should be mastered in the study.
引用本文： 羅靜,姚欣敏,吳劍,陳麗萍,劉虹. 乳腺癌保乳切除加經(jīng)乳腔鏡清掃腋窩淋巴結(jié)回顧分析. 華西醫(yī)學(xué), 2011, 26(7): 968-970. doi: 復(fù)制
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| 4. | 姜軍. 保乳術(shù)中乳腔鏡腋窩淋巴結(jié)清掃術(shù)臨床探討與爭論[J]. 中國實用外科雜志, 2008, 28(7): 536-538. |
| 5. | 郭美琴, 姜軍, 楊新華, 等. 吸脂法腔鏡腋窩淋巴結(jié)清除術(shù)野脫落細胞學(xué)研究[J]. 中華腫瘤防治雜志, 2009, 16(9): 710-712. |
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- 1. 駱成玉. 乳腺癌乳腔鏡腋窩淋巴結(jié)清掃手術(shù)的應(yīng)用價值[J]. 外科理論與實踐, 2010, 15(5): 464-467.
- 2. 中國抗癌協(xié)會乳腺癌專業(yè)委員會. 中國抗癌協(xié)會乳腺癌診治指南與規(guī)范(2007版)[J]. 中國癌癥雜志, 2007, 17(5): 410-428.
- 3. 蔣國勤, 危少華, 孫亦輝, 等. 乳腔鏡下乳腺癌腋淋巴結(jié)清除術(shù)35例分析[J]. 中華腫瘤防治雜志, 2009, 16(24): 961-1962.
- 4. 姜軍. 保乳術(shù)中乳腔鏡腋窩淋巴結(jié)清掃術(shù)臨床探討與爭論[J]. 中國實用外科雜志, 2008, 28(7): 536-538.
- 5. 郭美琴, 姜軍, 楊新華, 等. 吸脂法腔鏡腋窩淋巴結(jié)清除術(shù)野脫落細胞學(xué)研究[J]. 中華腫瘤防治雜志, 2009, 16(9): 710-712.
- 6. 林華, 駱成玉, 張鍵, 等. 乳腔鏡腋窩淋巴結(jié)清掃術(shù)治療乳腺癌可行性分析[J]. 中國實用外科雜志, 2008, 28(7): 547-549.