乳腔镜辅助保留乳头乳晕复合体改良根治术治疗早期乳腺癌的临床研究

Clinical research of mastoscopy-assisted nipple-areola complex preserving modified radical mastectomy in the treatment of early stage breast cancer

目的探讨乳腔镜辅助保留乳头乳晕复合体(nipple-areola complex,NAC)改良根治术治疗早期乳腺癌的安全性和可行性。方法选取2008年5月至2011年5月行乳腔镜辅助改良根治术患者413例,其中乳腔镜辅助保留NAC改良根治术127例,作为实验组,乳腔镜辅助传统改良根治术286例,利用倾向性评分匹配对比研究的方法,找出与保留NAC改良根治术最匹配的127例作为对照组进行对比研究。比较两组手术时间、术中出血量、清扫淋巴结个数、引流量、引流时间、术后皮肤坏死、瘀斑、血肿、感染、复发率、转移率、术后满意度和总体生存率。结果与对照组相比,观察组术后满意度明显高于对照组,差异有统计学意义(P<0.05)。两组手术时间、术中出血量、清扫淋巴结个数、引流量、引流时间、术后皮肤坏死、瘀斑、血肿、感染、复发率、转移率、总体生存率差异均无统计学意义(P>0.05)。结论乳腔镜辅助保留NAC改良根治术治疗早期乳腺癌安全、可行。

Objective To investigate the safety and feasibility of mastoscopy-assisted nipple-areola complex（NAC） preserving modified radical mastectomy in the treatment of early stage breast cancer. Methods From May 2008 to May 2011, a total of 413 cases accepted mastoscopy-assisted modified radical mastectomy, including 127 cases of mastoscopy-assisted NAC preserving modified radical mastectomy（observation group）, 286 cases of mastoscopy-assisted modified radical mastectomy. Using propensity score matching method, 127 cases were found out as the control group,best matched with the mastoscopy-assisted NAC preserving modified radical mastectomy. The operation time, bleeding volume, lymph node number harvested, drainage volume, drainage time, postoperative skin necrosis, ecchymosis, hematoma, infection, recurrence rate, metastasis rate, postoperative satisfaction and overall survival were compared between the two groups. Results Compared with control group, the satisfaction of the observation group was statistically higher（P0.05）. There were no statistically significant difference between two groups on the operation time, bleeding volume,lymph node number harvested, drainage volume, drainage time, postoperative skin necrosis, ecchymosis, hematoma, infection, recurrence rate, metastasis rate and overall surviva（P〈0.05）. Conclusion Mastoscopy-assisted NAC preserving modified radical mastectomy for early stage breast cancer is safe and feasible.