单孔充气法腔镜手术在早期乳腺癌保乳手术中的应用

Application of single-port air-filling technique in breast-conserving surgery for early breast cancer

目的探讨单孔充气法腔镜手术在早期乳腺癌患者保乳手术中的应用效果。方法采用回顾性研究方法,选取2020年6月—2023年6月于北京丰台医院接受保乳手术治疗的60例早期乳腺癌女性患者,根据手术方式不同将其分为两组:观察组(n=28)和对照组(n=32)。观察组患者采用单孔充气法腔镜保乳手术,对照组患者采用传统开放保乳手术。分析两组患者的围手术期指标,包括手术时间、术中出血量、术后引流时间、术后引流量,以及术后并发症、乳腺癌生存质量测评量表(FACT-B)评分、肿瘤复发情况和美容效果等相关指标。计量资料以均数±标准差(±s)表示,组间比较采用独立样本t检验;计数资料以例数和百分比[例(%)]表示,组间比较采用χ^(2)检验。结果两组患者均顺利完成手术,观察组患者的手术时间[(123.6±35.2)min]较对照组[(62.3±21.5)min]明显延长,且差异具有统计学意义(P<0.05)。观察组患者的术中出血量[(21.2±12.3)mL]较对照组[(38.3±18.6)mL]明显减少,且差异均具有统计学意义(P<0.05)。两组患者的术后引流时间、术后引流量比较,差异均无统计学意义(P>0.05),且均无皮肤坏死、伤口感染等术后并发症。术后1、6个月的美容效果评分方面,观察组[(10.8±0.8)、(11.6±1.3)分]均优于对照组[(8.9±0.9)、(9.2±1.2)分],且差异均具有统计学意义(P<0.05)。术后1、6个月FACT-B评分方面,观察组[(15.40±2.00)分、(18.60±2.10)分]均高于对照组[(11.10±2.90)、(17.10±2.70)分],且差异均具有统计学意义(P<0.05)。随访期内均无局部复发或远处转移病例。结论早期乳腺癌患者应用单孔充气法腔镜保乳手术不但肿瘤治疗效果确切,而且还具有理想的美容效果,极大地提高了患者的生活质量。

ObjectiveTo explore the application effect of the single-port air-filling technique in breast-conserving surgery for patients with early breast cancer.MethodsA retrospective study was conducted to select 60 female patients with early breast cancer who underwent breast-conserving surgery in the Beijing Fengtai Hospital from June 2020 to June 2023,and they were divided into two groups according to different surgical methods:observation group(n=28)and control group(n=32).Patients in the observation group were treated with single-port air-filling technique in breast-conserving surgery,while patients in the control group were treated with traditional open breast-conserving surgery.Perioperative indicators of the two groups of patients were analyzed,including operation time,intraoperative bleeding volume,postoperative drainage time,postoperative drainage volume,postoperative complications,Functional Assessment of Cancer Therapy-Breast(FACT-B)score,tumor recurrence,cosmetic effect and other related indicators.The measurement data were expressed as mean±standard deviation(±s),and independent sample t-test was used for comparison between groups;the count data were expressed as the number of cases and percentage,and the Chi-square test was used for comparison between groups.ResultsAll 60 patients had successfully completed the surgery.The operative time in the observation group was(123.6±35.2)min,which was significantly longer than that in the control group[(62.3±21.5)min],and the difference was statistically significant(P<0.05).The intraoperative bleeding volume in the observation group was(21.2±12.3)ml,which was significantly lower than that in the control group[(38.3±18.6)mL],and the differences were statistically significant(P<0.05).The postoperative drainage time and drainage volume between the two groups of patients has no statistically significant difference(P>0.05).There was no skin necrosis and wound infection in both groups.In terms of cosmetic effect scores at 1 and 6 months after surgery,the observation group[(10.8±0.8),(11.6±1.3)points]were superior to the control group[(8.9±0.9),(9.2±1.2)points],and the differences were statistically significant(P<0.05).In terms of postoperative FACT-B score at 1 and 6 months after surgery,the observation group[(15.40±2.00),(18.60±2.10)points]were higher than control group[(11.10±2.90),(17.10±2.70)points],and the differences were statistically significant(P<0.05).There was no local recurrence or distant metastasis in both groups during the follow-up period.ConclusionThe application of single-port air-filling technique in breast-conserving surgery for patients with early breast cancer not only has a definite tumor treatment effect,but also has ideal cosmetic effect,which greatly improves the quality of life of patients.