腔镜保乳手术联合射频消融术治疗早期乳腺癌的临床研究

Laparoscopic breast-conserving surgery combined with radiofrequency ablation to treat the early-stage breast cancer

目的探索腔镜保乳手术联合射频消融术治疗早期乳腺癌的可行性及疗效分析。方法回顾性分析2014年1月-2016年12月首都医科大学附属北京友谊医院普通外科行腔镜保乳手术的55例早期乳腺癌女性患者的病例资料，其中27例行腔镜保乳手术联合射频消融术，28例行单纯腔镜保乳手术而未行射频消融术，并通过t检验及，检验的统计学方法来明确两组之间的差异是否存在统计学意义。本临床研究主要评价指标为术后局部复发情况、脂肪液化的发病率、手术时间、术后住院时间、住院费用。结果腔镜保乳手术联合射频消融术组局部复发率低于未行射频消融术组（分别为0和7．69％）。同时，在脂肪液化这一可能影响术后康复的并发症方面，两组之间差异无统计学意义（P=0．236）。但是，腔镜保乳手术联合射频消融术组较未行射频消融术组住院费用高[分别为（4．1±0．7）万元和（2．3±0．6）万元，P〈0．05]。结论采用腔镜保乳手术联合射频消融术治疗早期乳腺癌，虽然因使用射频消融术相关设备和器械会导致住院费用增加，但此手术方式不仅具备清除乳腺残腔中微小癌残留的优点，而且在减少术后肿瘤复发率的同时不增加术后脂肪液化的发病率。因此，此手术方式将会成为乳腺癌微创手术治疗的重要发展方向之一。

Objective To analyze the clinical efficacy of the laparoscopie breast-conserving surgery combined with radiofrequency ablation to treat the early-stage breast cancer. Methods We collected 55 patients diagnosed early-stage breast cancer in retrospect, which started from January 2014 to December 2016. Twenty-seven of them were performed the laparoseopie breast-conserving segery combined with radiofrequency ablation while others went through laparoscopic breast-conserving surgery without radiofrequency ablation. Meanwhile, we adopted the student t-test and the chi-square test to compare results of two groups. More specific, the main indexes of this study are including the post-operative local recurrence, the incidence of fat liquefaction or the incision-infection, operation time, post-operative hospital stay and the hospitalization expense. Results The laparoscopie breast-conserving surgery combined with radiofrequency ablation group had low local-recurrence than the laparoscopie breast- conserving surgery group （0 and 7.69% ）. Additionally, there were no statistical differences between two groups in the incidence of fat liquefaction. However, The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had more hospitalization expense than the laparoscopic breast-conserving surgery group [ （4.1 ±0. 7） ten thousand yuan and （2.3 ± 0.6） ten thousand yuan, P 〈 0.05 ]. Conclusions Although the laparoscopic breast-conserving surgery combined with radiofrequency ablation group remarkably increased the hospitalization expense because of the utility of the radiofreqnency ablation related apparatus, it may provide the probability of shaving more residual tumor cell and may low down the recurrence, especially not rising up the incidence of the post-operative fat liquefaction. Therefore, this surgery method might be one of the potential developments in the minimal-invasive of early stage breast cancer.