乳腔镜腋窝淋巴结清扫的手术技术

Standardized skill of mastoscopic axillary lymph node dissection

目的 探讨乳腔镜腋窝淋巴结清扫的手术技术。方法 分析 4 73例次乳腔镜腋窝淋巴结清扫手术的临床效果及手术经验。结果 本组患者手术时间 2 2～ 15 6min ,平均 4 2min。术中出血很少 ,无一例因术中不易控制的大量出血而中转常规开放手术。各例患者取出淋巴结 4～ 38个 ,平均14个。所有病例术中、术后均未出现任何手术并发症。结论 乳腔镜腋窝淋巴结清扫特殊的手术视野使手术解剖清晰。遵循恰当的手术经路、手术方式标准化会绕过乳腔镜腋窝淋巴结清扫手术的学习曲线 ,加快手术速度 ,避免并发症的发生。

Objective To investigate the standardized skill of mastoscopic axillary lymph node dissection(MALND). Methods The clinical results and operation experiences of 473 mastoscopic lymph node dissections performed were analyzed. Result The operation time was 22—156 minutes with the average of 42. The operative bleeding was minimal. No case was converted to conventionally open operation because of the uncontrolled bleeding. Fourteen(4—38) lymph nodes were removed. There was no intra or post operative complication. Conclusion The special view of mastoscopic lymph node dissection makes operative dissection clear. The suitable procedure and standardization of the operative method can stride over the learning curve, so as to quicken the operation and avoid the operative complication.