Assessing the Clinical Efficacy and Effectiveness of Sentinel Lymph Node Biopsy Combined with Breast-Conserving Surgery for Early-Stage Breast Cancer

Objective:To analyze the impact of sentinel lymph node biopsy(SLNB)combined with breast-conserving surgery in the clinical treatment of early-stage breast cancer.Methods:80 patients with early-stage breast cancer admitted to the Second Department of Breast Surgery at Dezhou Second People’s Hospital from September 2020 to September 2022 were selected and randomly divided into a control group and an observation group using the random number table method,with 40 cases in each group.The control group underwent a modified radical mastectomy,while the observation group underwent SLNB combined with breast-conserving surgery.The surgical efficacy and prognosis between the two groups were compared.Results:The observation group exhibited shorter operation,hospitalization,and extubation times,as well as less intraoperative blood loss and drainage volume,all of which were significantly better than those in the control group(P<0.05).Additionally,the observation group demonstrated a higher rate of excellent breast cosmetology and quality of life,with lower complication incidence,significantly outperforming the control group(P<0.05).There was no statistical difference in the metastasis rate and recurrence rate between the two groups(P>0.05).Conclusion:The combination of SLNB and breast-conserving surgery proves highly effective for patients with early-stage breast cancer,presenting fewer complications and enhancing both breast cosmetic outcomes and quality of life.

Breast-conserving surgery and combined therapy for women breast cancer: a report of 216 cases

Objective： To explore the therapeutic effect and associated techniques of breast-conserving therapy on patients with clinical stage Ⅰ and stage Ⅱ breast cancer. Methods： 216 female patients with breast cancer underwent breast-conserving therapy from December 1993 to October 2004. Their data were analyzed retrospectively. The breast-conserving therapy consisted of lumpectomy or quadrant removal of the breast, postoperative radiotherapy, chemotherapy and endocrine therapy. Of them, 209 patients underwent axillary lymph node dissection. Results： There were no operative complications. 216 patients were followed-up 3 to 147 months, the medial follow-up time was 78 months. The local recurrence rate was 1.85%. Two patients died and one of them was not related with breast cancer. Presence or absence of fibrosis, shape of breast, asymmetry, pigmentation and handle were taken into consideration for cosmetic evaluation by the patients and experienced breast surgeon. Breasts were scored cosmetically as excellent and good in 199 patients, the rate of satisfactory was 92.13%. Conclusion： Breast-conserving therapy for early breast cancer is e safe end effective therapy. It has less trauma end less complications and can also raise the quality of life in the patients. But we must obey the strict indications and reasonable techniques.

Application of Deep Inspiration Breath Hold Technique in Radiotherapy After Breast- Conserving Surgery for Left Breast Cancer and Its Improvement on Cardiac Dose

Objective:To analyze the application of deep inspiration breath hold technique in radiotherapy after breast-conserving surgery for left breast cancer and the improvement of cardiac dose.Methods:A total of 45 patients with left breast cancer treated in our hospital after breast-conserving surgery were selected,and the selection time was set from January 2020 to August 2022.All patients received radiotherapy.The right breast,heart,and lung volumes,and dose parameters of the heart,lungs,right breast,and left anterior descending coronary artery were compared under free breathing(FB)and deep inspiration breath hold(DIBH)technical modes.Results:The heart volume of the DIBH group was smaller than that of the FB group,and the left and right lung volumes were significantly larger than those of the FB group.In the DIBH group,the heart dose parameters V5,proper lung dose parameters,and left anterior descending coronary artery dose parameters were found lower than that of the FB group,and the differences were statistically significant(P<0.05).Conclusion:Compared with FB,the DIBH technique can reduce the heart’s size and increase the lung volume when used for radiotherapy after breast-conserving surgery for left breast cancer.It also reduces the dose to the heart,right lung,and left anterior descending coronary artery,thus protecting the heart and lungs.

Whole breast ultrafractionation radiotherapy after breast-conserving surgery in early breast cancer: A single-center, prospective, observational study from China

Objective:This single-center,prospective,observational study was designed to investigate the toxicities,patient-reported outcome(PRO),and dosimetric analysis of whole breast ultrafractionation radiotherapy(RT)after breast-conserving surgery(BCS)in early breast cancer(BC).Patients and methods:Patients diagnosed with BC stage I,II and treated with BCS were enrolled.A dose of 26 Gray(Gy)in five fractions was prescribed to the whole breast and tumor bed.Clinical endpoints included toxicities,PRO,and dosimetric analysis.PRO was measured by the European Organization for Research and Treatment of Cancer general quality of life questionnaire(EORTC QLQ-C30)and the BC-specific questionnaire(EORTC QLQ-BR23)questionnaires.Results:Between January 2022 and June 2023,62 female patients were enrolled.The median age was 45 years.Most patients(83.9%)were diagnosed with pathological stage I disease.The median planning target volume(PTV)was 456.4 mL.The minimum,maximum,and mean doses,and D95(dose of PTV irradiated volume more than 95%)to PTV were 20.2,28.8,27.2,and 26.3 Gy,respectively.The median mean lung dose and percentage lung volume receiving 8 Gy(V8)were 3.6 Gy and 13.4%,respectively.The median mean heart dose,V1.5(percentage of organ volume irradiated with 1.5 Gy or higher),and V7(percentage of organ volume irradiated with 7 Gy or higher)were 0.6 Gy,6.8%,and 0.4%,respectively.Cosmetic effects before RT showed no obvious differences compared to that post RT.No toxicities of grade 3 or higher occurred.Five patients had asymptomatic radiation pneumonia(grade 1),and 12 patients had radiation dermatitis(grade 1).No factor was significantly related to radiation dermatitis or radiation pneumonia.For the EORTC QLQ-C30 and QLQ-BR23 questionnaires,all function and symptom scores before RT had no significant differences compared with that after RT,1−2 months after RT,and 3−4 months after RT.Ultrafractionation RT did not worsen PRO.The 1-year crude local control was 100%.Conclusion:Whole breast ultrafractionation RT after BCS in early BC has no severe toxicities and does not affect PRO.These results need to be further validated with a longer follow-up and a larger sample size.

Application of Ultimate Oncoplastic Surgery in Breast-Conserving Surgery

Objective To investigate the application of oncoplastic surgery in breast-conserving surgery.Methods We retrospectively analyzed the clinical data of 103 breast cancer patients who underwent breast-conserving surgery in the First Affiliated Hospital of Henan University.All the patients were female whose tumor volume-to-breast volume ratio was greater than 20%.Fifty-two patients were treated with oncoplastic breast-conversing surgery(observation group),and 51 patients were treated with traditional breast-conserving surgery(control group).The volume of resected tissue,subjective satisfaction with breast shape,objective score of breast shape,and follow-up were compared between the two groups.Results In the observation group,the weight of resected breast tissue was 64.2–172.1 g,with a median of 98.7 g.In the control group,the weight of resected breast tissue was 67.5–175.7 g,with a median of 102.3 g.After 12 months of follow-up,the subjective satisfaction rate and objective score of breast shape in the observation group were significantly better than those in the traditional breast-conserving surgery group(P<0.05).There was no recurrence,metastasis,or death in the two groups.There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion Oncoplastic breast-conserving surgery leads to better cosmetic results and a more satisfactory clinical results.

Diagnostic value of preoperative examination for evaluating margin status in breast cancer

BACKGROUND A positive resection margin is a major risk factor for local breast cancer recurrence after breast-conserving surgery(BCS).Preoperative imaging examinations are frequently employed to assess the surgical margin.AIM To investigate the role and value of preoperative imaging examinations[magnetic resonance imaging(MRI),molybdenum target,and ultrasound]in evaluating margins for BCS.METHODS A retrospective study was conducted on 323 breast cancer patients who met the criteria for BCS and consented to the procedure from January 2014 to July 2021.The study gathered preoperative imaging data(MRI,ultrasound,and molybdenum target examination)and intraoperative and postoperative pathological information.Based on their BCS outcomes,patients were categorized into positive and negative margin groups.Subsequently,the patients were randomly split into a training set(226 patients,approximately 70%)and a validation set(97 patients,approximately 30%).The imaging and pathological information was analyzed and summarized using R software.Non-conditional logistic regression and LASSO regression were conducted in the validation set to identify factors that might influence the failure of BCS.A column chart was generated and applied to the validation set to examine the relationship between pathological margin range and prognosis.This study aims to identify the risk factors associated with failure in BCS.RESULTS The multivariate non-conditional logistic regression analysis demonstrated that various factors raise the risk of positive margins following BCS.These factors comprise non-mass enhancement(NME)on dynamic contrastenhanced MRI,multiple focal vascular signs around the lesion on MRI,tumor size exceeding 2 cm,type III timesignal intensity curve,indistinct margins on molybdenum target examination,unclear margins on ultrasound examination,and estrogen receptor(ER)positivity in immunohistochemistry.LASSO regression was additionally employed in this study to identify four predictive factors for the model:ER,molybdenum target tumor type(MT Xmd Shape),maximum intensity projection imaging feature,and lesion type on MRI.The model constructed with these predictive factors exhibited strong consistency with the real-world scenario in both the training set and validation set.Particularly,the outcomes of the column chart model accurately predicted the likelihood of positive margins in BCS.CONCLUSION The proposed column chart model effectively predicts the success of BCS for breast cancer.The model utilizes preoperative ultrasound,molybdenum target,MRI,and core needle biopsy pathology evaluation results,all of which align with the real-world scenario.Hence,our model can offer dependable guidance for clinical decisionmaking concerning BCS.

Oncoplastic Breast Surgery Using Spindle Shaped-Partial Mastectomy for Early Breast Cancer in the Upper Quadrant Area

Background: Oncoplastic surgery is becoming more common, however, only several reports have been published in Japan. We report the results of simple oncoplastic surgery for Japanese patients with early breast cancer in the upper quadrant area. Methods: In seven patients with a past history of breast-feeding and ptotic breasts, we performed oncoplastic surgery involving partial mastectomy and the resection of excess skin and parenchymal tissue. Results: None of the patients received a contralateral operation to produce symmetrical breasts. The width of the resected excess skin tissue ranged from 20 to 50 mm, with the mean width being 30 mm, and its length ranged from 50 to 90, with the mean length being 77 mm. The width of the resected gland tissue ranged from 40 to 65 mm, with the mean width being 53 mm, and its length ranged from 70 to 100 mm, with the mean length being 97 mm. The cosmetic results were excellent. Conclusions: Oncoplastic surgery using spindle shaped-resection was successfully performed in patients with upper quadrant lesions, and the cosmetic results were excellent.

Intensity-modulated radiotherapy for breast cancer:a systematic review

Objective:The aim of this study was to assess the long-term effect of breast conservation with breast intensitymodulated radiotherapy (IMRT) for early-stage breast cancers.Methods:Pub Med,EMBASE,Cochrane Library,Chinese Biomedical Literature Database were searched to identify relevant original published trails,and the references of eligible studies were manually screened.Randomized controlled trails reported in any language,comparing breast IMRT with conventional radiotherapy (RT) in patients with early-stage breast cancer were eligible for inclusion.Two investigators independently assessed the quality of included trials and extracted data.The RevMan 5.0 software was used for statistical analysis.Results:Four trials involving 1440 patients were included.The results showed that in the IMRT group,the occurrence of acute moist dermatitis,the edema of the mammary gland and the occurrence of hyperpigmentation were lower than those of RT group,the pooled risk ratio value and 95% confidence interval were 0.28 (0.17-0.48),0.03 (0.00-0.21) and 0.06 (0.02-0.15) respectively.The use of IMRT did not correlate with pain and quality of life,but the presence of moist desquamation did significantly correlate with pain and reduced quality of life.Conclusion:The currently available evidence showed that IMRT significantly reduces the occurrence of moist acute dermatitis anywhere in the breast and alleviates the suffering of patients and improves the quality of life of patients.Future large-scale,high-quality,double-blind trials are needed.

Imaging of the treated breast post breast conservation surgery/oncoplasty: Pictorial review

Mammographic appearance of the normal breast is altered in the post-operative setting. It is essential to be aware of the normal findings as well as to identify features of recurrent disease with particular emphasis on radiologicalpathological concordance. Digital breast tomosynthesis and volumetric breast density add incremental value in this clinical setting. We present a pictorial review of various cases to illustrate normal post-operative findings as well as mammographic features suspicious for recurrent disease.

Advances in Oncoplastic Breast Surgery

Evidence from six prospective,randomized trials has shown that breast-conserving surgery(BCS)is a safe alternative to mastectomy,and this led to a heightened interest in achieving and balancing local control and cosmetic outcome post-surgery.However,it is also becoming apparent that conventional BCS techniques may not produce cosmetically favorable results for patients who present with ill-defined or poorly situated breast tumors.Other factors that are commonly found in Chinese women,such as small-volume and denser breasts,also contribute to the difficulty in achieving an optimal cosmetic outcome post-surgery,thus necessitating the need for oncoplastic breast surgery techniques to be employed.This article serves as an overview of the recent advances and principles of oncoplastic breast surgery,as well as the use of autologous fat grafts to improve cosmetic results and eliminate remaining smaller deformities post-surgery.

Comparison of breast-conserving surgery and mastectomy in early breast cancer using observational data revisited:a propensity score-matched analysis

Recent observational studies showed that breast-conserving surgery(BCS) resulted in superior survival compared to mastectomy in breast cancer patients. This study compared the clinical outcomes of BCS and mastectomy using propensity score(PS)matching analysis, which had advantages over conventional methods in reducing bias. Nonmetastatic breast cancer patients who underwent BCS and mastectomy were matched 1:1 based on their PS. We used the Kaplan-Meier method and Cox-regression model to estimate the treatment effects. A total of 2,866 patients with a median follow-up time of 67 months were included in the original study population. Although the mastectomy cohort(N=1,219) had more advanced disease compared to the BCS cohort(N=1,647), LRFS was similar between the two groups(93.8% vs. 92.4%, P>0.05). BCS(vs. mastectomy) was associated with improved DFS(73.8% vs. 58.7%, P<0.01) and CSS(91% vs. 78.2%, P<0.01) in the original population. In the PS-matched population(N=1,668), clinicopathological features were equally distributed between the two cohorts. BCS(vs. mastectomy) was not associated with improved DFS(70.7% vs. 66.9%, P>0.05) or CSS(87.5% vs. 84.9%, P>0.05). We found that PS methods reduce bias when estimating treatment effects using observational data. BCS and mastectomy show equivalent outcomes in nonmetastatic breast cancer patients.

Multicenter prospective study of magnetic resonance imaging prior to breast-conserving surgery for breast cancer

Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging （MRI） prior to breast-conserving surgery for breast cancer.Methods The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012.The participants were allocated to a breast-conserving surgery group （breast-conserving group） or a total mastectomy group （total mastectomy group）.Enhanced MRI was used to measure breast volume,longest diameter of tumor and tumor volume.The correlations between these measurements and those derived from histopathologic findings were assessed.The relationships between the success rate of breast-conserving surgery and MRI-and pathology-based measurement results were statistically analyzed in the breast-conserving group.Results The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group.Allocation to these groups was based on clinical indications and patient preferences.The cut-off for concurrence between MRI-and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm.In the total mastectomy group,the confidence interval for 95％ concurrence of these measurements was 35.41％-44.63％.Correlation coefficients for MRI and histopathology-based measurements of breast volume,tumor volume and tumor volume/breast volume ratio were r=0.861,0.569,and 0.600,respectively （all P ＜0.001）.In the breast-conserving group,with 0.30 cm taken as the cut-off for concurrence,the 95％ confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98％-44.01％.The subjective and objective success rates for breast-conserving surgery were 100％ and 88.54％,respectively.Conclusions There were significant correlations between dynamic enhanced MRI-and histopathology-based measurements of the longest diameter of breast lesions,breast and tumor volumes,and breast volume/tumor volume ratios.Preoperative MRI examination improves the success rate of breast-conserving surgery.

A multi-center investigation of breast-conserving surgery based on data from the Chinese Society of Breast Surgery(CSBrS-005)

Background:Although breast-conserving surgery is one of the standard treatments for breast cancer,few studies have assessed its recent implementation in China.We aimed to clarify the current real-world status of breast-conserving surgery in China.Methods:This cross-sectional survey relied on data collected by the Chinese Society of Breast Surgery(CSBrS)to examine patients who underwent this surgery between January 2018 and December 2018.The survey was conducted using a uniform electronic questionnaire to collect information,including clinical and pathological data on these patients.Results:Overall,4459 breast-conserving surgeries were performed in 34 member units of CSBrS,accounting for 14.6%of all breast cancer surgeries performed in these units during the study period.In patients who underwent breast-conserving surgery with information on tumor size available,more than half(61.2%)of the tumors were smaller than 2 cm in diameter,and only 87(3.2%)tumors were larger than 4 cm in diameter.Among patients who underwent breast-conserving surgeries,457(10.2%)patients received neoadjuvant therapy before the surgery.Among patients with a reported margin width,34(2.0%)patients had a margin of≤2 mm,and 1530(88.2%)of them had a margin of>5 mm.Conclusions:This study demonstrated the rates of breast-conserving surgery in member units of the CSBrS,and introduced the characteristics and surgical margins of patients who underwent this surgery.This information helps describe the real-world status of breast-conserving surgery in China.

单孔悬吊法腔镜保乳手术与开放保乳手术在早期乳腺癌治疗中的对照研究

目的探讨单孔法腔镜保乳与开放保乳手术在早期乳腺癌治疗中的临床应用效果。方法选取2014年11月至2015年6月于北京友谊医院诊断为Ⅰ、Ⅱ期乳腺癌行根治性手术的患者54例,其中行单孔法腔镜保乳手术的患者26例（腔镜组）,行开放保乳手术患者28例（开放组）,对根治性、美容效果评分等进行评估。结果 54例患者均成功地相应完成单孔法腔镜保乳或开放保乳手术。术后随访13~24个月（19.13±3.24个月）,两组均无局部复发或远处转移病例。术后三个月进行美容效果评估：腔镜组对手术美容效果感觉＂非常满意＂者比率（96.15%）明显高于开放组（64.29%）,差异有显著性（P〈0.001）。两组术后均无皮肤坏死、切口下方积液或血清肿等并发症。结论单孔悬吊法腔镜保乳手术可以在保证早期乳腺癌肿瘤根治性的同时,较开放保乳手术获得更好的美容效果。

单孔法全腔镜局部扩大切除术进行保乳手术的临床应用

目的探讨单孔法全腔镜局部扩大切除术进行保乳手术在乳腺癌治疗中的手术技巧和应用价值。方法总结2014年11月至2015年6月以早期乳腺癌行单孔法全腔镜局部扩大切除术进行保乳手术的23例患者的临床资料,对根治性、美容效果评分等进行评估。结果 23例患者均成功完成单孔法全腔镜局部扩大切除术。术后随访时间6～13个月（平均随访时间10.4个月）,无局部复发或远处转移。术后3个月美容效果评分：非常满意20例（87.0%）,比较满意3例（13.0%）,无一般或不满意病例。术后无皮肤坏死、切口下方积液或血肿等合并症发生。结论单孔法全腔镜局部扩大切除术进行保乳手术可以在保证早期乳腺癌肿瘤根治性的同时,获得更好的美容效果。

开放保乳术与单孔法腔镜保乳术治疗早期乳腺癌的疗效及对患者生存质量的影响

目的探讨开放保乳术与单孔法腔镜保乳术治疗早期乳腺癌的疗效及对患者生存质量的影响。方法选取我院2014年1月至2017年1月收治的186例Ⅰ、Ⅱ期乳腺癌为研究对象,根据手术方法分为开放组(89例)和单孔组(97例),比较两组围术期指标、切口总长度、美容效果、术后疼痛评分、乳腺癌生命质量测定量表(FACT-B)评分、术后常见并发症等情况。结果186例患者均成功完成保乳术,单孔组无中转开放手术病例,成功率100%;单孔组手术时间长于开放组(P<0.05),术中出血量少于开放组(P<0.05);两组腋窝清扫淋巴结数量、术后引流总量、引流时间比较,差异均无统计学意义(P>0.05);单孔组术后切口总长度短于开放组(P<0.05);单孔组术后乳房美容效果满意度为95.88%,高于开放组的77.53%(P<0.05);单孔组术后疼痛评分高于开放组(P<0.05);单孔组术后FACT-B评分高于开放组(P<0.05),单孔组术后常见并发症发生率为2.06%,低于开放组的22.48%(P<0.05);随访12~27个月,中位随访时间为19个月,两组患者上肢活动良好,无局部复发或远处转移病例。结论单孔法腔镜保乳术治疗早期乳腺癌可保证与开放保乳术相同的根治作用,同时还具有手术创伤小、并发症少、美容效果更佳、生存质量更高等优势。

表柔比星新辅助化疗联合腔镜下保乳术治疗Ⅱ、Ⅲ期乳腺癌的疗效与安全性研究

目的:探讨表柔比星新辅助化疗联合腔镜下保乳术治疗Ⅱ、Ⅲ期乳腺癌的临床疗效与安全性.方法:选取2014年1月—2015年1月我院收治的96例Ⅱ、Ⅲ期乳腺癌患者作为研究对象.按随机数字表法分为对照组与试验组,各48例.所有患者均接受表柔比星联合环磷酰胺与多西他赛新辅助化疗方案,对照组接受传统乳腺癌保乳术,试验组接受腔镜下的乳腺癌保乳术治疗,比较两组治疗效果及3年预后情况.结果:两组手术用时、术中淋巴结清扫数量比较,差异无统计学意义(P>0.05);试验组平均引流量少于对照组,拔管时间短于对照组,差异有统计学意义(P<0.05);两组有效率、3年生存率、远处转移率比较,差异无统计学意义(P>0.05);试验组中位无进展生存期长于对照组,局部复发率低于对照组,差异有统计学意义(P<0.05);两组治疗后并发症均为Ⅰ~Ⅱ级程度,经对症治疗或停药后缓解、消失.结论:表柔比星新辅助化疗联合腔镜下乳腺癌保乳术治疗Ⅱ、Ⅲ期乳腺癌的临床疗效理想且安全性较高,能够有效降低手术医源性损伤及术后局部复发率,具有临床应用及推广价值.

单孔充气法腔镜保乳手术治疗早期乳腺癌的临床效果

目的观察单孔充气法腔镜保乳手术治疗在早期乳腺癌患者中的临床效果。方法选取2017年11月~2019年11月北京市房山区良乡医院乳腺外科收治的86例早期乳腺癌患者作为研究对象,依据随机数字表法将其分为观察组及对照组,每组各43例。观察组患者行单孔充气法腔镜保乳手术,对照组患者行开放保乳手术。比较两组患者的围术期指标、术后常见并发症、乳房外观满意度情况。结果86例患者均成功完成保乳术,成功率为100.00%。观察组患者的手术时间长于对照组,术中出血量少于对照组,切口总长度短于对照组,差异有统计学意义(P<0.05);两组患者的术后引流总量、引流时间及住院时间比较,差异均无统计学意义(P>0.05)。观察组患者的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者的乳房外观满意度高于对照组,差异有统计学意义(P<0.05)。结论单孔充气法腔镜保乳手术治疗早期乳腺癌的临床效果与开放保乳手术相比,具有创伤小、并发症少的优势,能获得更优的美容效果。

胸腹腔镜手术联合血府逐瘀汤及全面营养支持治疗食管癌的临床研究

目的探讨胸腹腔镜手术联合血府逐瘀汤及全面营养支持治疗食管癌的临床价值，旨在提升食管癌临床治疗水平。方法选取我院2011年1月～2013年1月收治的110例食管癌患者为研究对象，采取随机双盲法将患者分为研究组及对照组各55例，对照组患者应用胸腹腔镜联合手术治疗，研究组患者在对照组治疗基础上联合血府逐瘀汤及全面营养支持治疗，观察两组患者的治疗效果、并发症情况、术后胃肠功能恢复时间及住院时间、出院时体重、患者对治疗方法及效果的满意程度，随访3年，对比两组患者癌症复发率及生存率，并采取匹兹堡睡眠质量指数（PSQI）及癌症患者生活质量核心量表（QOL-C30）评估患者近一个月睡眠质量及生活质量。结果两组患者均成功完成手术，疗效均较好；研究组患者总并发症发生率、3年复发率及生存率、总满意率分别为3．64％、18．18％、85．45％、96．36％，对照组分别为18．18％、40．00％、72．73％、81．82％，研究组患者总并发症率低于对照组，3年复发率及生存率、总满意率均显著高于对照组，差异均有统计学意义（P〈0．05）；研究组患者胃肠功能恢复时间及住院时间明显短于对照组，PSQI评分及QOL-C30量表评分、出院时体重均明显优于对照组，差异均有统计学意义（P〈0．05）。结论食管癌应用胸腹腔镜手术治疗前后进行全面营养支持，并联合血府逐瘀汤治疗效果显著提升，并发症少，胃肠功能恢复快，住院时间短，3年癌症复发率明显下降，生存率提升，且患者睡眠质量、生活质量及营养状况佳，满意度高，具有极高地临床应用及推广价值。

乳腺癌外科治疗的研究进展与展望

外科治疗在乳腺癌综合治疗中发挥基石作用。近年来随着精准医疗和大数据医疗等理念的提出和多学科诊疗模式的开展,乳腺癌的治疗正向着个体化、精准化、规范化、综合化的方向发展。前哨淋巴结活检的技术愈发成熟,应用范围进一步推广;新辅助治疗后保乳手术的可行性得到认可;乳房重建和肿瘤整形技术使乳腺癌治疗已逐渐由单纯的疾病治疗发展为乳房外形乃至功能的恢复;乳腺癌的微创治疗方法如腔镜手术、射频消融等备受青睐。国内各医疗中心开展临床研究,为乳腺癌外科治疗的发展提供中国数据。本文针对近年来乳腺癌外科治疗领域的现状及热点问题进行分析探讨。