早期乳腺癌乳腔镜腋窝淋巴结清扫的近期疗效

Short-term efficacy of mastoscopic axillary lymph node dissection for the patients with early breast cancer

目的了解早期乳腺癌患者保乳手术同时行乳腔镜腋窝淋巴结清扫的近期治疗效果。方法30例符合保乳手术指征的患者，按随机数字表法分为试验组和对照组，每组15例，均行保乳手术，再分别行乳腔镜腋窝淋巴结清扫和常规腋窝淋巴结清扫。观察比较两组的近期治疗效果。结果试验组手术时间（88．0±18．0）min，明显长于对照组的（68．0±12．5）min，差异有统计学意义（P=0．001），试验组上肢水肿发生率[6．7％（1／15）]及肋间臂神经损伤发生率（0）较对照组[60．0％（9／15）、40．0％（6／15）]显著降低，差异有统计学意义（P=0．002、0022），而两组术中出血量、淋巴结清除数目、术后总引流量、术野残留癌细胞发生率比较差异无统计学意义[（18．0±12．2）m1比（21．3±9．0）ml；（14．6±5．0）枚比（16．4±3．6）枚；（87．9±25．1）ml比（86．3±13．8）ml；6．7％（1／15）比13．3％（2／15）]（P〉0．05）。结论乳腔镜腋窝淋巴结清扫能获得与常规腋窝淋巴结清扫相当的淋巴结清除数目，术后不良反应少，近期效果良好。

Objective To analyze the short-term efficacy of mastoscopic axillary lymph node dissection for the patients with early breast cancer who undergo breast-conserving surgery. Methods Thirty patients who met the standard of breast-conserving surgery were divided into two groups by random digits table with 15 cases each. All of these patients underwent breast-conserving surgery,then study group underwent mastoscopic axillary lymph node dissection while control group underwent open technique. The short-term efficacy was observed and compared between two groups. Results The operation time in study group [（88.0 ± 18.0） mini was longer than those in control group [（68.0 ± 12.5） mini with significant difference （P = 0.001 ）. The incidence of upper extremity edema[ 6.7% （1/15）] and intercostobrachial nerve injury （0） in study group was lower than those in control group[ 60.0%（9/15 ） ,40.0%（6/15 ） ] with significant difference （P = 0.002,0.022）. There was no significant difference in blood loss, nodes harvest, total drainage volume and residual cancer cells between two groups [ （ 18.0 ± 12.2 ） ml vs. （21.3 ± 9.0） ml; 14.6 ± 5.0 vs. 16.4 ±3.6; （87.9 ±25.1） ml vs. （86.3 ± 13.8） ml;6.7% （1/15） vs. 13.3% （2/15）] （P 〉0.05）. Conclusions Mastoscopic axillary lymph node dissection has the similar nodes harvest with open technique. The incidence of adverse reaction is lower, and the short-term effect is better.