临床Ⅰ期和Ⅱ期乳腺癌腔镜腋窝淋巴结清扫术效果及预后分析  

Analysis of the effect and prognosis of endoscopic axillary lymph node dissection for clinical stage Ⅰ and Ⅱ breast cancer patients

作　　者：张毅[1] 杨新华[1] 周艳[1] 钟玲[1] 范林军[1] 郭美琴[1] 姜军[1] 

机构地区：[1]第三军医大学西南医院乳腺疾病中心,重庆400038

出　　处：《中华乳腺病杂志（电子版）》2010年第1期15-17,共3页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨临床Ⅰ、Ⅱ期乳腺癌腔镜腋窝淋巴结清扫术的可行性。方法本院2006年1月至2008年1月对临床Ⅰ、Ⅱ期乳腺癌患者行腔镜下腋窝淋巴结清扫术55例,同时选取传统腋窝淋巴结清扫术63例,对两组手术时间、出血量、淋巴结清扫数量、腋下引流液量及预后进行比较。定量资料的分析采用t检验;定性资料的比较用χ2检验。结果腔镜手术组手术时间平均121.0min,术中出血51.0ml,平均每例清扫淋巴结数量17.3枚,术后总引流量平均208.0ml,随访1～3年术后复发转移者2例;对照组手术时间平均70.0min,术中出血平均80.0ml,平均每例清扫淋巴结19.5枚,术后总引流量平均350.0ml,术后复发转移者2例。腔镜手术组手术时间较传统手术长,但术中出血及术后引流液明显低于传统手术(P<0.05)。两组间近期复发转移率比较,差异无统计学意义(χ2=0.02,P=0.89)。结论腔镜手术可以达到传统手术的治疗效果。Objective To study the clinical effect and technical feasibility of endoscopic axillary lymph node dissection for stage Ⅰ and Ⅱ breast cancer patients. Methods From January 2006 to January 2008, 118 patients with stage Ⅰ and Ⅱ breast cancer were treated with endoscopic axillary lymph node dissection （the EALND group, n ： 55） and conventional axillary lymph node dissection （the CALND group, n = 63）, respectively. The operation time, bleeding amount, number of lymph nodes dissected, axillary drainage amount and prognosis were compared between the two groups. Student＇s t test and Chi-square test were used for statistical analysis. Results In the EALND group, the mean operation time was 121. 0 minutes, the intraoperative bleeding amount was 51.0 ml, the mean number of lymph nodes dissected was 17. 3, the total postoperative axillary drainage was 208.0 ml; the follow-up of 1-3 years showed 2 patients had recurrence and metastasis. In the CALND group, the mean operation time was 70. 0 minutes, the intraoperative bleeding amount was 80.0 ml, the mean number of lymph nodes harvested was 19.5, the total postoperative axillary drainage was 350.0 ml; and postoperative recurrence and metastasis were in 2 patients. The operation time was longer in the EALND group than in the CALND group, but the intraoperative bleeding and postoperative drainage of the EALND group were significantly less than those of the CALND group （P〈0.05） ; short term outcome had no significant difference between the two groups （x^2 = 0.02, P = 0.89）. Conclusion Endoscopic axillary lymph node dissection can obtain similar therapeutic effect with conventional techniques.

关 键 词：乳腺肿瘤 内窥镜 腋窝淋巴结清扫术 

分 类 号：R737.9[医药卫生—肿瘤]