胸肌入路淋巴结清扫在乳腺癌Auchincloss手术中的应用

Application of pectoral approach lymph node dissection in Auchincloss surgery for breast cancer

目的:探讨胸肌入路淋巴结清扫在乳腺癌改良根治术一式(Auchincloss)手术中的应用价值.方法:以2017年1月-2019年1月为时间段,选取番禺区中医院收治的乳腺癌患者60例,将其随机分为两组,各30例.采取常规电刀手术治疗对照组患者,采取Auchincloss手术治疗观察组,且术中行经胸肌入路锁骨下淋巴结清扫术.比较两组手术情况、并发症以及生存质量.结果:在手术情况上,两组术中出血量、引流量及手术时间等对比差异存在统计学意义(P<0.05).在并发症方面,对照组发生率为6.67%(2/30),而观察组发生率为26.67%(8/30),二者对比差异存在统计学意义(P<0.05).在生存质量方面,两组躯体、生理、社会功能、情感职能等评分对比差异存在统计学意义(P<0.05).结论:胸肌入路淋巴结清扫在乳腺癌Auchincloss手术中的应用效果显著,即可彻底清除淋巴结,且术中出血量少,引流量多,手术时间短,还可减少相关并发症,提升患者生存质量,因此值得推广和应用.

Objective:To evaluate the value of lymph node dissection by pectoralis muscle approach in Auchincloss surgery for breast cancer.Methods:From January 2017 to January 2019,60 cases of breast cancer patients admitted to Panyu Hospital of Chinese Medicine were selected and randomly divided into 2 groups,with 30 cases in each group.Patients in the control group were treated with conventional electrosurgical surgery,and patients in the observation group were treated with Auchincloss surgery.Subclavian lymph node dissection was performed through the pectoral approach.The surgical conditions,complications and quality of life of the two groups were compared.Results:In terms of surgical conditions,there were statistical differences in intraoperative blood loss,drainage volume and operation time between the two groups(P<0.05).In terms of complications,the incidence of complications was 6.67%(2/30)in the control group and 26.67%(8/30)in the observation group,showing a statistical difference(P<0.05).In terms of quality of life,there were statistical differences in the scores of physical,physiological,social and emotional functions between the two groups(P<0.05).Conclusion:The application of pectoral approach lymph node dissection in Auchincloss surgery for breast cancer has a significant effect,which can completely remove the lymph nodes,reduce intraoperative blood loss,increase drainage volume,shorten operation time,reduce related complications,and improve the quality of life of patients,so it is worthy of promotion and application.