腔镜下早期乳腺癌保乳和前哨淋巴结活检术的应用效果观察

The clinical application value of breast-conserving and sentinel lymph node biopsy under laparoscopy in early breast cancer

目的:探讨腔镜经腋窝小切口行早期乳腺癌保乳和前哨淋巴结活检术的临床价值及效果。方法:103例早期乳腺癌病人根据手术方法分为腔镜组(41例)和传统开放组(62例),比较2组前哨淋巴结检出数量及检出率、围手术期指标、乳房外观满意度、术后并发症等情况。结果:103例病人均成功完成手术,腔镜组无中转开放病例,成功率100%;2组前哨淋巴结检出数量及检出率、围手术期指标、术后并发症比较差异均无统计学意义(P>0.05);腔镜组术后乳房外观满意度为100.0%,明显高于传统开放组的83.87%(P<0.05);随访6~11个月,中位随访时间为8.5个月,2组病人上肢活动良好,无局部复发或远处转移病例。结论:腔镜经腋窝小切口行保乳和前哨淋巴结活检术治疗早期乳腺癌与传统开放手术疗效相当,且手术切口隐蔽、乳房美容效果更好、生存质量更高,值得临床推广。

Objective:To investigate the clinical application value of endoscopic small axillary incision for breast-conserving and sentinel lymph node biopsy under laparoscopy in early breast cancer.Methods:One hundred and three patients with early breast cancer were divided into the endoscopic group(n=41)and traditional open group(n=62)according to the surgical methods.The number and detection rate of sentinel lymph nodes,perioperative indexes,breast appearance satisfaction and postoperative complications were compared between two groups.Results:The operations of all patients were successfully completed.No transfer case was found in endoscopic group,and the success rate of the endoscopic group was 100%.The differences of the number and detection rate of sentinel lymph nodes,perioperative indexes and postoperative complications between two groups were not statistically significant(P>0.05).The postoperative breast appearance satisfaction of the endoscopic group was 100.0%,which was significantly higher than that of traditional open group(83.87%)(P<0.05).Two groups were followed for 6 to 11 months,and the median follow-up time was 8.5 months.No transfer case was found in endoscopic group.The upper limb movement were good,and there was no local recurrence or distant metastasis in two groups.Conclusions:The clinical effects of the endoscopic small axillary incision for breast conserving combined with sentinel lymph node biopsy in treating early breast cancer is similar to that of traditional open surgery.In addition,the surgical incision is concealed,the cosmetic effect of breast is better,the quality of life is higher,and which is worthy of clinical promotion.