【摘要】 目的 探討乳腺癌保乳切除加經乳腔鏡清掃腋窩淋巴結的可行性和手術難點。 方法 將2007年2月－2011年2月行乳腺癌保乳切除手術的27例患者，分成乳腔鏡腋窩清掃組（乳腔鏡組）11例和常規腋窩清掃組（常規組）16例，比較兩組患者手術時間、術中出血量、術中清掃淋巴結數、術后引流時間及引流量等。 結果 手術時間:乳腔鏡組（186.36±11.20） min，常規組（158.13±25.29） min，兩組差異有統計學意義（P=0.002）；術中出血量:乳腔鏡組（61.82±51.54） mL，常規組（103.75±42.56） mL，兩組差異有統計學意義（P=0.030）；兩組術中清掃淋巴結個數、術后引流時間、引流量比較，差異均無統計學意義（P gt;0.05）；隨訪1個月~4年，無一例發生腫瘤局部復發或戳孔轉移。 結論 乳腺保乳切除加經乳腔鏡清掃腋窩淋巴結可以安全應用于早期乳癌的保乳治療，操作者需學習一定的手術技巧。
【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乳腔鏡清掃腋窩淋巴結回顧分析. 華西醫學, 2011, 26(7): 968-970. doi: 復制