乳腺癌Kodama法改良根治术的临床应用研究

Clinical Research of Axillary Lymph Node Dissections in Breast Cancer Using Kodama Mode

目的:探讨对腋淋巴结阳性乳腺癌患者行Kodama术式的应用临床及意义。方法:322例乳腺癌患者,154例临床腋淋巴结阳性乳腺癌患者采用Kodama术式,168例行常规Auchinclos改良根治术式,对两组情况进行比较,同时随访观察患者的预后情况。结果:两组患者手术时间差异无统计学意义,行改进术式患者腋下清扫淋巴结总数及L3组淋巴结数较常规术式多,两组差异有统计学意义,Kodama术式组患者5年无瘤生存率为58.9%,常规术式组患者5年无瘤生存率为51.1%,两组差异无统计学意义。结论:对临床腋淋巴结阳性乳腺癌患者行全腋下淋巴结清扫具有一定的临床应用价值,采用Kodama术式有利于对L3组淋巴结的清扫。

Objective： To identify the clinical applications and significance of ter-group axillary lymph node dissection using Kodama mode in patients with breast cancer. Methods： The subjects of the present study were 322 patients with clinically apparent axillary lymph nodes. Among them, 154 were operated by Kodama mode and 168 were operated by normal Auchinclos axillary lymph node dissection. The regional lymph nodes were removed for pathological study. Follow-up studies were conducted to determine the disease-free survival of the patients. Results： The two groups had no statistical significance in surgical duration, but had statistical significance in axillary lymph nodes and ter-group axillary lymph nodes. The five-year disease-free survival of patients operated via Kodama mode was 58.9%, whereas that of the other group was 51.1%. The difference was not statistically significant. Conclusion： The procedure has specific clinical value for patients with clinically apparent axillary lymph nodes. Operation by Kodama mode enables easy dissection of the ter-group axillary lymph nodes