乳腺癌“逆行”改良根治术的近期疗效评价

A short term evaluation of the effectiveness of retrograde modified radical mastectomy

目的:评价乳腺癌逆行改良根治术的近期疗效。方法:将80例先清扫腋窝淋巴结再行乳腺切除的乳腺癌逆行改良根治术与84例传统改良根治术作比较,通过收集临床资料及术后随访评价两者的疗效。结果:改良根治术与逆行改良根治术两组病人平均手术时间分别为121.43min和120.63min,平均术后住院时间分别为7.49d和7.75d,平均术后引流管拔除时间分别为5.12d和5.00d,腋窝淋巴结清扫数量分别为25.49个和24.71个,病理证实淋巴结转移比例分别为42.86%和46.25%。病人术后伤口引流量,第1天改良根治术组平均引流量为168mL(50～300mL),逆行改良根治术组平均引流量为144mL(50～250mL),两组比较有显著性差异(P=0.013)。而两组术后随访并发症无统计学差异。结论:乳腺癌逆行改良根治术是在乳腺癌改良根治术基础上创新的一种手术方法,符合肿瘤手术学原理,在不增加手术难度的同时安全且未增加近期术后并发症。

Objective To evaluate the short term effectiveness of retrograde modified radical mastectomy.Methods Eighty patients undergoing retrograde modified radical mastectomy（mastectomy following axillary lymph nodes clearance）,compared with 84 patients undergoing radical mastectomy（Auchincloss＇ methods）.To evaluate the comparative effectiveness by means of short term follow-up,operating time,hospital stay,drainage amount,lymph nodes clearance and wound complications.Results The mean operating times of retrograde modified radical mastectomy and classical radical mastectomy were 121.43 min and 120.63 min respectively,the mean hospital stay was 7.49 day and 7.75 day respectively,the mean drainage time was 5.12 day and 5.00 day respectively,the amount of axillary lymph nodes excised was 25.49 and 24.71 respectively,the percentage of metastasis lymph nodes was 42.86% and 46.25% respectively.There was significance difference in the two groups of the first day drainage amount（P=0.013）.The mean first day drainage amount of patients who underwent classical radical mastectomy was 168 mL,ranging from 50～300 mL.The mean first day drainage amount of patients who underwent retrograde modified radical mastectomy was 144 mL,ranging from 50～250 mL.There were no difference of wound complications within the follow-up period between the two groups.Conclusions Retrograde modified radical mastectomy is a new operation technique,modifying the Auchincloss＇ radical mastectomy.It is in accord with the surgical principle in managing the malignant tumors.It is safe,easy to perform and not causing more complications.