电视乳腔镜乳腺癌腋窝淋巴结清扫86例临床分析

Mastoscopic axillary lymph node dissection for the patients with breast cancer

目的 分析电视乳腔镜乳腺癌腋窝淋巴结清扫的临床治疗效果。方法 对 86例乳腺癌患者行腋窝脂肪抽吸后 ,采用乳腔镜施行腋窝淋巴结清扫。结果 平均手术时间 5 5 3min。前 10例手术时间平均 10 3 2min ,后 76例平均 4 3 7min ,两者相差显著 (P <0 0 1)。术中出血很少 ,无一例因术中不易控制的出血而中转常规开放手术。平均每例取出淋巴结 15 3个 ,37例病理显示腋窝淋巴结受累 ,平均受累 3 6个。所有患者术中、术后均未出现明显并发症。术后平均随访 10 4个月 ,随访期间患者肩关节活动均良好 ,上肢无肿胀 ,无腋窝复发或套针处种植出现。结论 基于脂肪抽吸的乳腔镜腋窝淋巴结清扫手术 ,临床可行 ,不仅微创又保留功能和美观 ,生活质量提高 ,患者满意。

Objective To analyze the clinical effects of mastoscopic axillary lymph node dissection for the patients with breast cancer. Methods Following the liposuction of the axilla, axillary lymph node dissection was performed in 86 breast cancer patients by mastoscopy. Results The median duration of operation was 55.3 min. The operation time was obviously shorter for the last 76 patients than for the first 10 patients (P<0.001). The bleeding amount in operation was little, and no patient was intraoperatively transferred to routine open axillary lymph node dissection due to uncontrolled bleeding. A mean number of 15.3 lymph nodes were harvested. 37 patients showed involved lymph nodes. The mean number of involved lymph nodes in these patients was 3.6. There was no intra- and post-operation morbidity. After a median follow-up time of 10.4 months, no axillary relapse or trocar site implantation had occurred. Conclusion Mastoscopic axillary lymph node dissection (MALND) based on the liposuction of axilla is a minimally invasive and clinical feasible procedure. It manifests the functional and cosmetic effects and satisfies the breast cancer patients to certain extent.