保留神经血管及淋巴管在乳腺癌根治术中的应用  

Clinical value of retained neurovascular and lymphatic vessel in complete dissection of breast cancer

作　　者：王建[1] 王远东[1] 

机构地区：[1]广州医学院附属肿瘤医院胸外科,广东广州510095

出　　处：《实用医院临床杂志》2009年第3期79-80,共2页Practical Journal of Clinical Medicine

摘　　要：目的探讨腋淋巴结清扫的新技术及评价其临床疗效。方法对28例腋淋巴结肿大的乳腺癌患者行改良根治术,腋窝注射脂肪溶解液及脂肪抽吸后进行淋巴结清扫术,保留肋间臂神经、胸长神经及胸背神经。结果28例患者均手术顺利,完全保留了腋动静脉向下的分支,腋静脉附近的淋巴管,肋间臂神经、胸长神经及胸背神经。每例淋巴结清扫9-31枚,术后全部患者病理检查均有淋巴结转移1-9个,平均转移5.4个。随访1-6个月,患者均无腋窝肿瘤复发、肩关节活动障碍、上肢水肿等并发症。结论腋淋巴结清扫术中采用脂肪溶解液及脂肪缺吸方法,具有操作简单、省时、淋巴结清扫较彻底、神经血管损伤少及术后并发症少等优点。Objective To investigate a new technique of axillary lymph node dissection and evaluate its clinical effects.Methods 28 cases with breast cancer with axillary lymph node enlargement before operation underwent modified radical operation.Axillary lymph node dissection was performed after axillary injection of fat solvent and liposuction.In the all cases,Long Thoracic Nerve and Thoracodorsal nerve were preserved during operation.Results Average operative time was 100 minutes.Intraoperative bleeding was less.Pathological examination found metastasis of lymph node in all cases and average metastasis node was 5.4 in number.No obvious postoperative complications were found in all cases.Average postoperative follow—up was 6 months.No recurrence of axillary tumors,no edema of upper limb and paralysis was found and shoulder joint functions were excellent.Conclusions Application of fat solvent and liposuction have simplified manipulation,saving operative time with complete lymph node dissection,less nerve and blood vessels injuries and less postoperative complications etc.

关 键 词：乳腺癌 脂肪溶解液 淋巴结清扫术 手术后并发症 

分 类 号：R737.9[医药卫生—肿瘤]