乳腺癌保乳切除加经乳腔镜清扫腋窝淋巴结回顾分析

【】　目的　探讨乳腺癌保乳切除加经乳腔镜清扫腋窝淋巴结的可行性和手术难点。　方法　将2007年2月－2011年2月行乳腺癌保乳切除手术的27例患者，分成乳腔镜腋窝清扫组（乳腔镜组）11例和常规腋窝清扫组（常规组）16例，比较两组患者手术时间、术中出血量、术中清扫淋巴结数、术后引流时间及引流量等。　结果　手术时间乳腔镜组（186.36±11.20）min，常规组（158.13±25.29）min，两组差异有统计学意义（P=0.002）；术中出血量乳腔镜组（61.82±51.54）mL，常规组（103.75±42.56）mL，两组差异有统计学意义（P=0.030）；两组术中清扫淋巴结个数、术后引流时间、引流量比较，差异均无统计学意义（P>0.05）；随访1个月~4年，无一例发生肿瘤局部复发或戳孔转移。　结论　乳腺保乳切除加经乳腔镜清扫腋窝淋巴结可以安全应用于早期乳癌的保乳治疗，操作者需学习一定的手术技巧。【Abstract】　Objective　Toinvestigatethefeasibilityandsurgicaldifficultyofbreast-conservingresectionandendoscopy-assistedaxillarylymphnodedissectionforbreastcancerpatients.　Methods　Twenty-sevenpatientstreatedbybreast-conservingsurgeryfromFebruary2007toFebruary2011inourhospitalweredividedintoendoscopy-assistedaxillarylymphnodedissectiongroup(theEALNDgroup,n=11)andconventionalaxillarylymphnodedissectiongroup(theCALNDgroup,n=16).Then,wecomparedtheoperationtime,intra-operativebleedingvolume,numberoflymphnodesdissected,postoperativedrainagetimeandamountbetweenthetwogroups.　Results　TheoperationtimewassignificantlylongerintheEALNDgroupthanthatintheCALNDgroup(186.36±11.20)vs.(158.13±25.29)minutes,P=0.002.Theintra-operativebleedingvolumeoftheEALNDgroupwassignificantlylessthanthatoftheCALNDgroup(61.82±51.54)vs.(103.75±42.56)mL,P=0.030.Therewerenosignificantdifferencesbetweenthetwogroupsinthenumberoflymphnodesdissected,postoperativedrainagetimeandamount.Follow-upwasdoneforonemonthtofouryears,duringwhichnolocalrecurrenceortrocardisplacingoccurred.　Conclusion　Thebreast-conservingresectionandendoscopy-assistedaxillarylymphnodedissectioncanbesafelyusedinearlybreastcancerpatients,andsurgicalskillsshouldbemasteredinthestudy.