中国实用外科杂志

中国实用外科杂志 ›› 2005, Vol. 25 ›› Issue (10): 1-610.

• 论著 •    下一篇

腔镜辅助小切口乳腺癌改良根治术 (附47例报告)

郭美琴 姜军 杨新华 范林军 贺青卿 张毅 张帆   

  1. 第三军医大学西南医院乳腺疾病中心(重庆，400038)
  • 收稿日期:2005-04-21 修回日期:2005-05-08 出版日期:2005-10-20 发布日期:2005-10-20

  • Received:2005-04-21 Revised:2005-05-08 Online:2005-10-20 Published:2005-10-20

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摘要：

目的 观察腔镜辅助小切口乳腺癌改良根治术的近期疗效。方法 2003年10月至2005年2月对47例0～Ⅱ期(AJCC)乳腺癌病人施行腔镜辅助小切口乳腺癌改良根治术，并与既往相同分期的乳腺癌行传统改良根治术进行比较。结果 手术保留乳头乳晕复合体35例，切除乳头乳晕复合体12例。胸壁切口长度（907±157）cm（60～115cm），手术时间（25991±48.27）min(180～360min)，术中出血量（20152±4665）mL(130～280mL)，术后引流量（13482±4968）mL(60～230mL)，引流时间（700±240）d(5～11d)，清扫腋窝淋巴结数目（1482±503）枚(15～26枚)。与既往32例相同分期乳腺癌实施传统改良根治术相比，腔镜手术组手术时间稍长，清扫腋窝淋巴结数目、术后引流量和引流时间及术后并发症发生率差异无显著性，术中出血量明显减少，切口明显缩小，美容效果良好。平均随访105个月，无局部复发和远处转移。结论 腔镜辅助小切口乳腺癌改良根治术为Ⅰ、Ⅱ期乳腺癌病人的手术治疗提供了新的术式，有利于乳房重建。

Abstract:

assisted modified radical mastectomy with small incision：a report of 47 cases. Guo Meiqin,Jiang Jun,Yang Xinhua,et al.Breast Disease Center,Southwest Hospital,Third Military Medical University,Chongqing 400038,China Abstract Objective To evaluate the shortterm results of the endoscopeassisted modified radical mastectomy with small incision (EMRM). Methods A total of 47 patients were treaded by EMRM (group A).The American Joint Committee on Cancer pathological staging was stage 0 6cases,stageⅠ16cases,stageⅡa 19cases,stageⅡb 6cases.Thirty two cases of same stage breast cancer treated with traditional modified radical mastectomy (MRM)(group B) in last year were retrospectively reviewed.All available data including operation time,blood loss in operation,number of the resected lymph nodes,total postoperative lymph flow and duration of drainage,the complications and the incision length of chest wall were analyzed. Results In our study,nippleareolar complex (NAC) was conserved in 35 cases.The incision length of chest wall were 907±157cm(range,60~115cm) in group A,1822±298cm in group B.The blood loss in operation were 20152±4665mL (range,130~280mL) in group A,35313±10697mL(range,150~600mL) in group B.Significant difference existed in incision length and blood loss in operation between two groups.In group A,the total postoperative lymph flow was 13482±4968mL(range,60~230mL),the duration of drainage was 700±240d(range,5~11d),the number of resected lymph nodes were 1482±503(range,15~26),the operation time in group A was 25991±4827min (range,180~360min),it was longer than that in group B 23963±6469 min(range,130~310min).But no significant difference existed between two groups.The cosmetic result in group A was much better than that in group B.There were no local and distant recurrences after a median followup of 105 months. Conclusion EMRM is an effective surgery with superior cosmetic results for early stage breast cancer compared with traditional MRM.