超声刀清扫腋窝淋巴结预防乳腺癌术后淋巴漏的临床研究

Clinical research of ultrasonic scalpel clean axillary lymph nodes to prevent lymphatic fistula after breast cancer surgery

目的探讨乳腺癌手术使用超声刀清扫腋窝淋巴结对术后淋巴漏发生率的影响。方法回顾性分析本院2010年6月～2012年2月期间行乳腺癌改良根治术患者186例,其中85例术中采用超声刀清扫腋窝淋巴结,101例采用电刀,比较两组术后24h引流量、腋窝引流管留置时间、手术总时间、淋巴结检出数及皮下积液的发生率。结果两组相比,手术总时间及淋巴结检出数的差异无统计学意义(P>0.05),术后24h引流量、腋窝引流管留置时间及皮下积液的发生率,超声刀组均较电刀组明显减少,且差异有统计学意义(P<0.05)。结论在乳腺癌改良根治术中使用超声刀清扫腋窝淋巴结可以预防术后淋巴漏的发生。

Objective To explore the incidence of postoperative lymph leakage by using ultrasonic scalpel dissection of axillary lymph nodes in breast cancer surgery. Methods 186 breast cancer patients were included in this study from June 2010 to February 2012. They were divided into two groups.The dissection of axillary lymph nodes in UAS group （n=85） were performed by using ultrasonic scalpel.The operation was performed by electro scalpel in electro- surgery group （n=101）. To compare the two groups including draining volume in the postoperative 24 hours, draining time, operating time, detection amount of lymph node, the incidence of subcutaneous fluid. Results The operative time and detection amount of lymph node were not different between the two groups （P 〉 0.05）. The volume of drainage in postoperative 24 hours and the time of drainage of UAS group were less than electro-surgery group （P 〈 0.05）, the incidence of subcutaneous fluid in UAS group was lower than that in electro-surgery group （P 〈 0.05）： Conclusion Using UAS clean axillary lymph nodes in modified radical mastectomy can reduce the incidence of postoperative lymphatic fistula and the suffering of patients. It can be applied widely in radical mastectomy.