三种手术方式治疗Ⅰ-Ⅱ期乳腺癌的疗效及预后比较

Comparison of the curative effect and prognosis of three surgical methods in the treatment of stageⅠ-Ⅱbreast cancer

目的比较三种手术方式治疗Ⅰ-Ⅱ期乳腺癌的疗效及预后。方法回顾性分析2013年3月至2018年3月接受手术治疗的127例乳腺癌女性患者病例资料,根据术式的不同分为三组,即腔镜组(40例,行单孔法腔镜保乳术)、传统组(44例,行传统开放保乳术)、根治组(43例,行开放全乳切除术)。采用SPSS 23.0统计分析软件,手术相关指标以(±s)表示,多组间采用单因素方差分析;并发症、局部复发率、转移率等计数资料以率表示,比较采用χ^(2)检验。P<0.05为差异有统计学意义。结果手术时间:传统组<根治组<腔镜组(P<0.05);术中出血量、淋巴结清扫数量、住院时间、并发症总发生率:腔镜组<传统组<根治组(P<0.05);乳房美观程度优良率:腔镜组>传统组>根治组(P<0.05);三组患者术后3年局部复发率、转移率相比,差异无统计学意义(P>0.05)。结论腔镜保乳术、传统开放保乳术、改良根治术治疗Ⅰ-Ⅱ期乳腺癌的疗效相当,中远期复发、转移风险也无明显差异,但腔镜保乳术在乳房美观、术后恢复方面具有一定优势。

Objective To compare the efficacy and prognosis of three kinds of operation for stageⅠ-Ⅱbreast cancer.Methods The data of 127 patients with breast cancer who underwent surgical treatment from March 2013 to March 2018 were retrospectively analyzed.They were divided into three groups according to the operation types:endoscopic group(40 cases underwent single hole endoscopic breast conserving surgery),traditional group(44 cases underwent traditional open breast conserving surgery),and radical resection group(43 cases underwent open total mastectomy).SPSS 23.0 statistical analysis software was used,and the operation-related indicators were expressed as(±s),and single-factor analysis of variance was used among multiple groups;the count data such as complications and metastasis rate were expressed as rates,andχ^(2) test was used for comparison;P<0.05 was considered statistically significant.Results Operation time:traditional group<radical group<endoscopic group(P<0.05);Intraoperative bleeding,number of lymph node dissections,length of hospital stay and total incidence of complications:endoscopic group<traditional group<radical group(P<0.05);The excellent and good rate of breast beauty:endoscopic group>traditional group>radical mastectomy group(P<0.05);There was no significant difference in local recurrence rate and metastasis rate among the three groups(P>0.05).Conclusion Endoscopic breast-conserving surgery,traditional open breast-conserving surgery and modified radical mastectomy have similar efficacy in the treatment of stageⅠtoⅡbreast cancer,and there is no significant difference in the risk of mid and long term recurrence and metastasis.However,endoscopic breast-conserving surgery has certain advantages in breast aesthetics and postoperative recovery.