乳腺癌手术保留肋间臂神经和胸前神经的临床研究

Clinical Study on Breast Cancer Surgery with Intercostobrachial Nerve and Nervi Thoracales Anteriores Reservation

目的研究保留肋间臂神经和胸前神经在乳腺癌根治术中的效果及复发情况。方法将我院60例确诊为乳腺癌的患者根据手术方式不同分为保留肋间臂神经及胸前神经的治疗组(30例)和切除肋间臂神经及胸前神经的对照组(30例)。比较两组患者的术中情况、术后并发症发生率及复发转移情况。结果治疗组的手术时间为(79.4±11.5)min,明显长于对照组的(65.3±10.4)min(P<0.05)。术后6个月,治疗组的并发症发生率为6.7%,显著低于对照组的36.7%(P<0.05)。手术1年后,治疗组的复发/转移发生率为13.3%,显著低于对照组的36.7%(P<0.05)。结论采用保留肋间臂神经和胸前神经的乳腺癌根治术,可减少患侧上肢感觉及运动功能损伤,同时可以减少患侧骨转移及癌肿复发率。

Objective To explore the effect and recurrence of intercostobrachial nerve and nervi thoracales anteriores reservation in radical resection of breast cancer. Methods 60 cases of patients with radical resection of breast cancer in our hospital were selected. All cases were divided into the treatment group （reservation of intercostobrachial nerve and nervi thoracales anteriores） and the control group （resection of intercostobrachial nerve and nervi thoracales anteriores） equally. The intraoperative indicators, incidence of postoperative complications and recurrence rate were compared between two groups. Results The operation time of treatment group was （79.4± 11.5） rain, significantly longer than （65.3 ±10.4） rain of control group （P 〈0.05）. 6 months after surgery, the incidence of complications of treatment group was 6.7%, significantly lower than 36.7% of control group （P 〈0.05）. 1 year after surgery, the incidence of recurrence or micrometastasis of treatment group was 13.3%, significantly lower than 36.7% of control group （P〈0.05）. Conclusions Radical resection of breast cancer with intercostobrachial nerve and nervi thoracales anteriores reservation can reduce the damage of sensory and motor function impairment of upper limb of affected side, and reduce the rate of bone metastasis and tumor recurrence rate of affected side.