关键词: 乳腺癌, 腔镜, 腋窝淋巴结清扫, 溶脂法, 非溶脂法

Abstract: Selection and evaluation of the endoscopic axillary lymph node dissection in breast cancer        YANG Wei-ge， NI Xiao-jian. Department of Breast Surgery，Fudan University Affiliated Zhongshan Hospital，Shanghai 200032，China
Corresponding author：YANG Wei-ge，E-mail：weigeyang@hotmail.com
Abstract    There is controversy but constantly developments in creation the working space for endoscopic axillary lymph node dissection using liposuction or non-liposuction. The non-liposuction method can obtain the same good vision for endoscopic operation as well as the liposuction methods, with same benefit in thorough manipulation and minimally invasiveness. Besides, it fits the routine procedure of open surgery, with no limit to the size of the lymph nodes. It can also provide a total removal of lymphatic fat tissue, and the specimens can be easily removed trough the peri-areolar incision. The non-liposuction method almost overcome all the disputes of liposuction method, except the lack of use in breast conservative surgery for tumors located in the lower inner quadrant. For breast surgeons with proficient laparoscopic techniques, endoscopic handling for sentinel lymph node biopsy or axillary lymph node dissection is technically sufficient. However, the understanding of axillary fascia levels and breast aesthetics is even more important. The extension of surgical time and the lack of laparoscopic training for some breast surgeons are the main factors restricting the wide application of endoscopic axillary lymph node procedures with non-liposuction. However, with the progress of surgical instruments and the implementation of surgical standardized resident training the procedure is believed to have a wider application.

Key words: breast cancer, endoscopy, axillary lymph node dissection, liposuction, non-liposuction