Rotter淋巴结清扫在乳腺癌手术中的必要性探讨  

Necessity of Rotter Lymph Node Dissection in Breast Cancer Surgery

作　　者：陆国芬[1] 马德奎[1] 吴慧 LU Guofen;MA Dekui;WU Hui(The First People's Hospital of Zhaoqing City,Zhaoqing 526060,China)

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526060

出　　处：《中国医学创新》2020年第12期11-15,共5页Medical Innovation of China

摘　　要：目的:探讨Rotter淋巴结清扫在乳腺癌手术中的必要性。方法:选取2014年5月-2016年8月本院收治的82例乳腺癌患者,根据治疗方法不同分为对照组与观察组,每组41例。对照组给予乳腺癌改良根治术治疗(术中不清扫Rotter淋巴结),观察组在对照组基础上联合Rotter淋巴结清扫治疗。比较两组手术指标、肿瘤标志物、生活质量及并发症情况;随访3年,比较两组局部复发与远处转移情况。结果:观察组手术时间长于对照组(P<0.05);两组术中出血量、引流量及住院时间比较,差异均无统计学意义(P>0.05);观察组术后7 d癌胚抗原(CEA)与乳腺癌抗原(CA15-3)水平均低于对照组(P<0.05);两组术后7 d各项生活质量评分均高于术前,且观察组均高于对照组(P<0.05);两组术后皮瓣坏死、皮下积液及切口感染等并发症发生率比较,差异无统计学意义(P>0.05);观察组术后局部复发与远处转移发生率均低于对照组(P<0.05)。结论:乳腺癌患者清扫Rotter淋巴结未增加手术创伤,能降低肿瘤标志物水平,有助于提高患者生活质量,降低局部复发与远处转移,未增加并发症发生率,可常规开展进行。Objective:To investigate the necessity of Rotter lymph node dissection in breast cancer surgery.Method:A total of 82 cases of breast cancer patients in our hospital from May 2014 to August 2016 were selected.They were divided into control group and observation group according to different treatment methods,41 cases in each group.The control group treated with modified radical mastectomy for breast cancer(the Rotter lymph node was not removed during the surgery).The observation group treated with Rotter lymph node dissection on the basis of the control group.The surgical indicators,tumor markers,quality of life and complications were compared between the two groups.All patients were followed up for 3 years,local recurrence and distant metastasis were compared between the two groups.Result:The operative time of the observation group was higher than that of the control group(P<0.05).There were no statistically significant differences in intraoperative blood loss,drainage volume and hospital stays between the two groups(P>0.05).The levels of Carcinoembryonic antigen(CEA)and breast cancer antigen(CA15-3)in the observation group were lower than those in the control group on 7 d after surgery(P<0.05).All the life quality scores on 7 d after the surgery of the two groups were higher than before surgery,and those of the observation group were higher than those in the control group(P<0.05).There were no statistically significant differences in the incidence of skin flap necrosis,subcutaneous effusion and incision infection between the two groups(P>0.05).The incidence of local recurrence and distant metastasis in the observation group were lower than those in the control group(P<0.05).Conclusion:The Rotter lymph node dissection in breast cancer patients does not increase the surgical trauma.It can reduce the level of tumor markers,help to improve the quality of life of patients,reduce local recurrence and distant metastasis,and do not increase the incidence of complications.It can be carried out routinely.

关 键 词：乳腺癌 改良根治术 Rotter淋巴结清扫 

分 类 号：R737.9[医药卫生—肿瘤]