保留中、下胸肌神经的Patey手术41例分析  

Patey operation with reservation of medium and inferior pectoral nerves: a clinical analysis of 41 cases

作　　者：吴瑞正[1,2,3] 齐晓伟[1] 张帆[1] 

机构地区：[1]第三军医大学西南医院乳腺外科,重庆400038 [2]广西医科大学第八附属医院 [3]广西省贵港市人民医院普通外科,广西贵港53700

出　　处：《中华乳腺病杂志（电子版）》2013年第4期12-14,共3页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨保留中、下胸肌神经的乳腺癌改良根治术Ⅱ式(Patey术)的可行性,并观察手术效果。方法回顾性分析2010年1月至2011年3月在第三军医大学西南医院乳腺外科行保留中、下胸肌神经Patey术治疗的41例乳腺癌患者的临床资料。结果所有患者均顺利完成该手术。手术时间为72～107 min之间,平均时间为87 min;术中出血量在15～120 ml之间,平均出血量为75 ml;腋窝淋巴结清扫数量在15～42枚之间,平均清扫23枚淋巴结;转移淋巴结数目在2～32枚之间,平均转移数为7.7枚。全组无皮瓣坏死、切口感染、术后出血等并发症,3例拔除引流管后出现皮下积液,再次置管行负压引流后痊愈。术后3个月随访,所有患者同侧胸大肌外形良好、患侧上肢活动自如。结论保留中、下胸肌神经的Patey术对于术后胸大肌功能的恢复和胸廓形态的维持具有重要意义,是一种具有应用价值的手术方式。Objective To explore the feasibility of Patey operation with reservation of medium and inferior pectoral nerves （modified radical mastectomy Ⅱ）.Method The clinical data of 41 cases undergoing Patey operation with reservation of medium and inferior pectoral nerves between January 2010 and March 2011 in Department of Breast Surgery,Southwest Hospital of the Third Military Medical University were analyzed retrospectively.Results The operations were performed successfully in all patients.The mean operation time was 87 min （72-107 min） and the mean blood loss was 75 ml （15-120 ml）.The mean number of axillary nodes dissected was 23 （15-42） and the mean number of metastatic axillary nodes was 7.7 （2-32）.There were no postoperative complications including flap necrosis,infection of incision and bleeding.Three cases had subcutaneous effusion after the removal of drainage tube and recovered well by negative pressure drainage.In 3-month follow-up,all patients showed good appearance of ipsilateral major pectoral muscle and the upper extremities on the affected side could move freely.Conclusion Patey operation with reservation of medium and inferior pectoral nerves shows great benefit for the postoperative functional recovery of major pectoral muscle as well as the maintenance of thorax,which is worth of clinical application.

关 键 词：乳腺肿瘤 胸肌 神经支配 乳房切除术 改良根治性 

分 类 号：R737.9[医药卫生—肿瘤] R615[医药卫生—临床医学]