乳腺癌保留腋窝的临床试验进展

腋窝分期不仅可以判断乳腺癌病人的预后,而且可以指导后续治疗。腋窝淋巴结清扫术(axillary lymph node dissection,ALND)是传统的腋窝分期术式,但是,ALND后并发症的出现会严重影响病人的生活质量。前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)已经成为腋窝临床阴性病人的主流分期术式,减少了腋窝手术后的并发症。随着系统治疗及新辅助治疗的不断进步,相关研究对于部分低负荷腋窝淋巴结转移的病人以及新辅助治疗后淋巴结转阴的病人进行了保留腋窝的探索。

腋臭根治术皮肤原位回植技术的临床应用

目的探讨保留腋窝皮肤腋臭根治皮片原位回植的关键技术。方法腋臭根治用保留腋窝皮肤的手术方法完成清除皮下组织、顶泌汗腺和大小汗腺后对手术创面进行彻底止血、用连续褥式缝合固定皮片、安放有效的引流、用改良的弹性打包包扎加压皮片。结果结果显示止血效果好,引流充分,手术创腔排空彻底,皮片对位良好并能使皮片紧贴创面下组织,利于皮片成活。结论彻底止血、有效引流、连续褥式缝合皮片和弹性打包式包扎是保留腋窝皮肤腋臭根治皮片原位回植皮片成活的关键技术。

Presentation of Axillary Metastases from Occult Breast Carcinoma

Axillary presentation from occult breast cancer is uncommon and continues to be a diagnostic and therapeutic challenge to physicians. Once the diagnosis of adenocarcinoma metastatic to an axillary lymph node has been confi rmed, a preoperative workup should be done. The current experience is based on several relatively small retrospective reviews and case reports. It is diffi cult to determine the best management of occult breast cancer. However, treatment of axillary lymph node dissection is recommended for local control and complete staging information. Treatment of breast should be a choice between breast conservation with whole-breast radiotherapy and mastectomy. Adjuvant systemic treatment should be offered.