亚甲蓝染色法联合乳房隐蔽切口在乳腺癌保乳术中的应用

Application of Methylene Blue Staining Combined with Breast Concealed Incision in Breast Cancer Breast Conserving Surgery

目的:评价亚甲蓝手术腔染色法联合乳房隐蔽切口在早期乳腺癌保乳术中的临床使用价值。方法:回顾性分析2012年1月-2015年1月在厦门市妇幼保健院接受乳腺癌手术,肿瘤直径≤3 cm的100例资料。根据不同手术技巧分为常规组和亚甲蓝组。常规组实施常规标准保乳术,亚甲蓝组实施亚甲蓝染色法联合乳房隐蔽切口术,采用乳晕切口、乳房下皱襞或乳房腋尾部切口等乳房隐蔽切口。术中先用亚基蓝染色标记肿瘤在内扩大手术切除范围。完整切除肿瘤后,手术残腔亚甲蓝环染标记断端,后再行手术腔环切取材,切缘送病理检查评估。比较两组手术效果、乳房美容效果。结果:亚甲蓝组术后拔管时间早于常规组,术中自体组织充填及术中切缘再次切除率低于常规组,术后美容优良率高于对照组(P<0.05);术中出血及手术时间两组间比较,差异均无统计学意义(P>0.05)。结论:对有适应证的早期乳腺癌患者,在保乳术中采用亚甲蓝手术腔染色法,联合乳房隐蔽切口可以精确切除肿瘤,且美观度良好。

Objective:To evaluate the clinical value of Methylene Blue staining combined with breast concealed incision in early breast cancer breast conserving surgery.Method:From January 2012 to January 2015,100 cases with tumor diameter≤3 cm who underwent breast cancer surgery in our hospital were analyzed retrospectively.According to the different surgical techniques,they were divided into the routine group and the Methylene Blue group.The routine group was treated with standard breast conserving operation,the Methylene Blue group was treated with Methylene Blue staining combined breast concealed incision surgery.The areola incision,submammary fold or breast axillary tail incision and other breast concealed incisions were used.During the operation the tumor was marked with Methylene Blue staining to expand the scope of surgical resection.After complete resection of the tumor,the broken end of the residual cavity was marked with Methylene Blue,and then the material was circumcised and sent for pathological diagnosis.The effect of treatment and cosmetic effect in the two groups were compared.Result:In the Methylene Blue group,the time of extubation was earlier than that in the routine group,the incidence of intraoperative autogenous tissue filling and intraoperative margin resecting were lower than those of the routine group,and the postoperative cosmetic rate was better than that of the routine group(P<0.05).There was no significant difference between the two groups in intraoperative bleeding and operation time(P>0.05).Conclusion:In the early stage of breast cancer patients with indications,Methylene Blue staining combined with breast concealed incision can be used in breast conserving surgery,and the tumor can be excised accurately with good appearance,and the aesthetic effect is good.