Ⅰ、Ⅱ期乳腺癌锁骨下淋巴结清扫的探讨

An improved method for the excision of subclavian lymph nodes in patients with stage Ⅰ ,Ⅱ mammary carcinoma

目的 探讨一种Ⅰ、Ⅱ期乳腺癌锁骨下淋巴结清扫的新术式。方法 回顾性分析1998年3月至2000年5月采用的改良术式治疗的14例乳腺癌。在乳腺癌改良Ⅱ式Auchincloss术式基础上,平第2肋软骨上缘水平劈开胸大肌,于喙突起点处离断胸小肌,显露胸前神经,行锁骨下淋巴结彻底清扫。结果 各例病人均取得成功,锁骨下淋巴结清扫完全,无胸前神经损伤等并发症发生。结论 该术式为保护上肢功能、胸部美学及后期乳房再造提供了基础,是一种较好的术式。

Objective To investigate an improved method for the excision of subclavian lymph nodes in patients with stage Ⅰ , Ⅱ mammary carcinoma. Methods A retrospective analysis was made for 14 patients with stage Ⅰ ,Ⅱ mammary carcinoma who were operated on with the improved method in our hospital from March 1998 to May 2000. On the basis of Auchincloss method, we separated greater pectoral muscle on the upper edge level of the second costal cartillage and amputated smaller pectoral muscle at the coracoid process to expose anterior pectoral nerve. All subclavian lymph nodes in the patients were eradicated. Results The subclavian lymph nodes were resected thoroughly and no complications such as anterior pectoral nerve injury occurred in our group. Conclusion Our improved method is an applicable and excellent treatment for patients with stage Ⅰ , Ⅱ mammary carcinoma.