摘要
目的:探讨非溶脂腔镜腋窝淋巴结清扫术治疗乳腺癌的临床疗效、安全性、优势、手术规范与技巧。方法:前瞻性纳入2016年10月至2019年10月收治的96例乳腺癌患者。根据腋窝手术方式随机分为腔镜组(n=48,行非溶脂腔镜腋窝淋巴结清扫术)与对照组(n=48,行传统开放腋窝淋巴结清扫术)。对比分析两组临床资料及治疗结果。结果:两组手术时间、淋巴结清扫数量、淋巴结阳性率差异无统计学意义(P>0.05)。腔镜组手术切口、术中出血量、术后引流量、手术并发症发生率优于对照组,住院费用高于对照组,差异有统计学意义(P<0.05)。术后6个月,腔镜组肩关节活动度、生活质量评分均优于对照组,差异有统计学意义(P<0.05)。术后随访14~50个月,中位随访37个月,两组均未出现切口种植、局部复发及远处转移。结论:非溶脂腔镜腋窝淋巴结清扫术在保证腋窝淋巴结清扫效果的同时具有美容效果好、创伤小、并发症少等优势,改善了患者的术后生活质量,值得临床推广应用,但术者需要具备一定的腔镜下乳腺手术技术与技巧。
Objective:To investigate the clinical efficacy,safety,advantages,surgical standard and techniques of endoscopic axillary lymphadenectomy without liposuction for patients with breast cancer.Methods:In the prospective clinical study,96 patients treated from Oct.2016 to Oct.2019 were randomly assigned to endoscopy group(n=48,endoscopic axillary lymphadenectomy without liposuction)and control group(n=48,conventional axillary lymphadenectomy).The clinical data and therapeutic outcomes of the two groups were compared and analyzed.Results:No statistically significant differences were found in operation time,number of dissected lymph node and positive rate of lymph node between the two groups(P>0.05).Compared with the control group,the result of the endoscopy group had a qualitative leap in the following aspects:shorter surgical incision length,less intraoperative blood loss,fewer postoperative drainage volume and lower incidence of surgical complications.Comparatively,the endoscopy group required higher hospitalization costs(P<0.05).Six months after the operation,the endoscopy group had better feedback than the control group in terms of patient’s range of shoulder motion and functional assessment of cancer therapy-breast,and showed statistical significance as well(P<0.05).Postoperative following up lasted from 14 months to 50 months,with a median time of 37 months.During this period,neither group of patients experienced incision implantation,local recurrence or distant metastasis.Conclusions:Endoscopic axillary lymph node dissection without liposuction not only guarantees the effect of axillary lymph node dissection,but also has better cosmetic result,fewer trauma and complications,and improves the quality of life after surgery.It is worthy of clinical application and promotion,but sophisticated surgical skills are highly demanded.
作者
徐洁
陈曦
夏苗火
储诚森
鲍宗旋
冯萍
马立
XU Jie;CHEN Xi;XIA Miao-huo(Department of Thyroid and Breast Surgery,Anqing Hospital Affiliated to Anhui Medical University,Anqing 246003,China)
出处
《腹腔镜外科杂志》
2021年第4期246-251,共6页
Journal of Laparoscopic Surgery
基金
安徽医科大学校科学研究基金资助项目(2018xkj069)。
关键词
乳腺肿瘤
腋窝淋巴结清扫术
非溶脂
内窥镜检查
随机对照试验
Breast neoplasms
Axillary lymphadenectomy
None-lipolytic solution
Endoscopy
Randomized controlled trial
