溶脂辅助腋窝淋巴结清扫术临床应用分析
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摘要
目的探讨溶脂辅助在乳腺癌腋窝淋巴结清扫术中的临床价值。方法分析2015年1月—2019年2月的32例溶脂辅助腋窝淋巴结清扫术组及43例传统开放手术组患者资料,对比两组病例的手术切口长度,术中出血量、清扫淋巴结数、术后引流时间、术后1个月患侧肩关节外展最大角度、肋间臂神经损伤等指标。结果观察组的平均切口长度短、术中出血量少、术后引流时间短及肋间臂神经损伤发生率低,术后1个月患侧肩关节外展的最大角度大,差异有统计学意义(P<0.01),清扫淋巴结数量与对照组差异无统计学意义(P>0.05)。结论溶脂辅助在乳腺癌腋窝淋巴结清扫术中具有良好的临床应用价值,为乳腔镜腋窝淋巴结清扫术提供基础。
Objective To investigate the clinical value of auxiliary liposuction in axillary lymph node dissection for breast cancer.Methods Clinical data of 32 patients receiving auxiliary liposuction in axillary lymph node dissection and 43 patients receiving traditional surgery from January 2015 to February 2019 were compared for length of incision, volume of intraoperative bleeding, number of intraoperatively dissected lymph nodes, postoperative drainage time, maximum shoulder joint abduction angle measured at 1 month after operation, and incidence of intercostal nerve damage between the two groups.Results The observation group showed significantly lower average incision length, intraoperative bleeding volume, postoperative drainage time, and incidence rate of intercostal nerve damage, as well as significantly larger maximum shoulder joint abduction angle than the traditional group(P<0.01).There was no significant difference in the number of intraoperatively dissected lymph nodes between the two groups(P>0.05).Conclusion Auxiliary liposuction has high clinical values in axillary lymph node dissection, and provide a basis for mastoscopic axillary lymph node dissection.
Objective To investigate the clinical value of auxiliary liposuction in axillary lymph node dissection for breast cancer.Methods Clinical data of 32 patients receiving auxiliary liposuction in axillary lymph node dissection and 43 patients receiving traditional surgery from January 2015 to February 2019 were compared for length of incision, volume of intraoperative bleeding, number of intraoperatively dissected lymph nodes, postoperative drainage time, maximum shoulder joint abduction angle measured at 1 month after operation, and incidence of intercostal nerve damage between the two groups.Results The observation group showed significantly lower average incision length, intraoperative bleeding volume, postoperative drainage time, and incidence rate of intercostal nerve damage, as well as significantly larger maximum shoulder joint abduction angle than the traditional group(P<0.01).There was no significant difference in the number of intraoperatively dissected lymph nodes between the two groups(P>0.05).Conclusion Auxiliary liposuction has high clinical values in axillary lymph node dissection, and provide a basis for mastoscopic axillary lymph node dissection.
引文
[1] 骆成玉.乳腺癌治疗从标准到精准微创.首都医科大学学报[N].2016,37(3):331-335.
[2] 马燕飞,卢冠铭,陈永诚,等.采用乳腔镜腋窝淋巴结清扫术与常规腋窝淋巴结清扫术治疗乳腺癌的疗效比较[J].当代医药论丛,2014,12(14):236-237.
[3] 刘忠波.乳腔镜辅助乳腺癌保乳和完全腔镜腋窝淋巴结清扫手术的临床研究[J],中国处方药,2015,13(9):117-118.
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[5] 赵海涛,王慧穆,祝冒善,等.溶脂辅助在乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的应用[N].川北医学院学报,2017,32(3):391-394.
[6] Nakajo A,Arima H,Hirata M,et a1.Bidirectional Approach of Video-Assisted Neck Surgery(BAVANS):Endoscopic complete central node dissection with craniocaudal view for treatment of thyroid cancer[J].Asian J Endosc Surg,2017,10(1):40-46.
[7] 陈晓英,梁宁震,申龙海.浅析用乳腔镜手术对乳腺癌患者进行腋窝淋巴结清扫的临床效果[J].当代医药论丛,2015,13(8):238-239.
[8] 刘涛.保留胸前神经和肋间臂神经的乳腺癌手术的疗效分析[J].中外医疗,2017,36(32):45-47.
[9] 张月,王耀一,孙光源,等.腔镜下前哨淋巴结活检及腋窝淋巴结清扫在早期乳腺癌手术中的应用[J].实用癌症杂志,2015,30(9):1335-1338.
[10] 骆成玉,范克民,葛沙沙,等.血管细胞黏附分子-1评估乳腺癌乳腔镜腋窝淋巴结清扫手术血液转移风险的临床研究[N].首都医科大学学报,2017,38(2):308-312.
[11] 刘洋.乳腔镜辅助乳腺癌保乳与完全腔镜腋窝淋巴结清扫手术效果比较[J].临床研究,2017,25(1):199-200.
[12] 盛宇伟,任建强,于金玲,等.肿胀液溶脂法直视下乳腺癌腋窝淋巴结清扫术的临床效果分析[J].中国全科医学,2014,17(5):594-596.
[13] 刘嘉琦,何贵金.乳腔镜下腋窝淋巴结清扫术与常规腋窝淋巴结清扫术术后恢复及并发症的临床比较[J/CD ].中华乳腺病杂志(电子版),2017,11(4):218-222.
[2] 马燕飞,卢冠铭,陈永诚,等.采用乳腔镜腋窝淋巴结清扫术与常规腋窝淋巴结清扫术治疗乳腺癌的疗效比较[J].当代医药论丛,2014,12(14):236-237.
[3] 刘忠波.乳腔镜辅助乳腺癌保乳和完全腔镜腋窝淋巴结清扫手术的临床研究[J],中国处方药,2015,13(9):117-118.
[4] 杨杰,高明.乳腺癌术后上肢淋巴水肿危险因素的临床观察[J].浙江创伤外科,2015,20(1):114-116.
[5] 赵海涛,王慧穆,祝冒善,等.溶脂辅助在乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的应用[N].川北医学院学报,2017,32(3):391-394.
[6] Nakajo A,Arima H,Hirata M,et a1.Bidirectional Approach of Video-Assisted Neck Surgery(BAVANS):Endoscopic complete central node dissection with craniocaudal view for treatment of thyroid cancer[J].Asian J Endosc Surg,2017,10(1):40-46.
[7] 陈晓英,梁宁震,申龙海.浅析用乳腔镜手术对乳腺癌患者进行腋窝淋巴结清扫的临床效果[J].当代医药论丛,2015,13(8):238-239.
[8] 刘涛.保留胸前神经和肋间臂神经的乳腺癌手术的疗效分析[J].中外医疗,2017,36(32):45-47.
[9] 张月,王耀一,孙光源,等.腔镜下前哨淋巴结活检及腋窝淋巴结清扫在早期乳腺癌手术中的应用[J].实用癌症杂志,2015,30(9):1335-1338.
[10] 骆成玉,范克民,葛沙沙,等.血管细胞黏附分子-1评估乳腺癌乳腔镜腋窝淋巴结清扫手术血液转移风险的临床研究[N].首都医科大学学报,2017,38(2):308-312.
[11] 刘洋.乳腔镜辅助乳腺癌保乳与完全腔镜腋窝淋巴结清扫手术效果比较[J].临床研究,2017,25(1):199-200.
[12] 盛宇伟,任建强,于金玲,等.肿胀液溶脂法直视下乳腺癌腋窝淋巴结清扫术的临床效果分析[J].中国全科医学,2014,17(5):594-596.
[13] 刘嘉琦,何贵金.乳腔镜下腋窝淋巴结清扫术与常规腋窝淋巴结清扫术术后恢复及并发症的临床比较[J/CD ].中华乳腺病杂志(电子版),2017,11(4):218-222.