乳腔镜腋窝淋巴结清扫术的应用
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李小荣 E-mail:lixiaorong-x@hotmail.com

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Clinical application of mastoscopic axillary lymph node dissection
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    摘要:

    目的:探讨乳腔镜腋窝淋巴结清扫术的治疗效果及操作技巧。 方法:回顾分析2008年12月以来50例腔镜腋窝淋巴结清扫术和50例传统腋窝淋巴结清扫手术乳腺癌患者的临床资料。分别比较两组平均手术时间、出血量、清扫淋巴结数目、淋巴结转移数、住院时间及术后并发症的发生率。 结果:两组平均清扫淋巴结数目、淋巴结转移数、住院时间差异无统计学意义(P>0.05)。腔镜组平均手术时间为(221.85±19.61)min, 较常规手术组时间显著延长(P=0.000), 但术中出血量少(P=0.012), 术后并发症发生率低(P=0.034)。 结论:乳腔镜腋窝淋巴结清扫术具有创伤小、操作简单、并发症少、术后恢复快、瘢痕小等优点, 是一种值得推广的手术方法, 但腔镜操作延长了手术时间, 其手术技巧有待进一步提高。

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    Objective:To evaluate the therapeutic effect and surgical technique of mastoscopic axillary lymph node dissection (MALND). Methods:The clinical data of 100 patients with breast cancer undergoing mastoscopic (50 cases) or conventional (50 cases) axillary lymph node dissection since Dec. 2008 were retrospectively analysed. The parameters including the operating time, bleeding volume, number of lymph nodes removed, lymph node metastasis, hospital stay and occurrence of postoperative complication were compared respectively between the two groups. Results:No differences were noted in the average number of lymph node harvested, lymph node metastasis and hospital stay between the two groups (P>0.05). Although the mastoscopic procedure showed longer operating duration than conventional procedure[(221.85±19.61) min vs. (140.05±13.95) min] (P=0.000), it had less bleeding (P=0.012) and lower postoperative complication rate (P=0.034) than that of conventional surgery. Conclusions:MALND is worth being promoted for broad clinical applications owing to its advantages of minimal invasion, simple procedure, low complication rate, rapid recovery and invisible scar. However, the surgical technique of MALND remains to be further improved to reduce the prolonged operating time.

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丁波泥, 李小荣, 陈道瑾, 吴君辉, 钱立元.乳腔镜腋窝淋巴结清扫术的应用[J].中国普通外科杂志,2011,20(5):474-477.
DOI:10.7659/j. issn.1005-6947.2011.05.012

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  • 收稿日期:2009-11-09
  • 最后修改日期:2011-01-17
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  • 在线发布日期: 2011-05-15