腔镜乳腺癌保乳手术的争议与共识  

Controversy and consensus on endoscopic breast conserving surgery for breast cancer

作　　者：王文政 李继明 李志高[1] WANG Wen-zheng;LI Ji-ming;LI Zhi-gao(Department of Breast Surgery,Harbin Medical University Cancer Hospital,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院乳腺外科,黑龙江哈尔滨150081

出　　处：《中国实用外科杂志》2024年第11期1234-1238,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金面上项目(No.82073146)。

摘　　要：腔镜乳腺癌保乳手术作为乳腺癌治疗中的新术式,既存在争议也有一定共识。一方面腔镜乳腺癌保乳手术过程可能有促使癌细胞转移的风险,不同研究对切缘阴性和切缘宽度的定义差异较大,新辅助治疗后行保乳术受到肿瘤缩小的影响,对切除范围和安全切缘的判定存在困难。另一方面,早期乳腺癌病人适合选择腔镜保乳手术,且术前检查评估和术后观察护理方面已形成一定规范,腔镜保乳手术美观与功能效果较好,对病人心理健康有积极影响。目前,与传统手术对比,腔镜乳腺癌保乳手术局部复发率和病人生存率无明显差异,但仍需长期随访研究进一步证实。Endoscopic breast conserving surgery for breast cancer,as a new surgical method in the treatment of breast cancer,has both controversy and consensus.On the one hand,there may be a risk of promoting cancer cell metastasis during endoscopic breast cancer conserving surgery;different studies have different definitions of negative incisal margin and incisal margin width;breast conservation surgery after neoadjuvant therapy is affected by tumor shrinkage,and it is difficult to determine the resection scope and safe incisal margin.On the other hand,endoscopic breast conserving surgery is suitable for patients with early breast cancer;a certain standard has been formed in preoperative examination and evaluation and postoperative observation and nursing;endoscopic breast conserving surgery has good aesthetic and functional outcomes and positively influences patients'mental health.At present,compared with traditional surgery,there is no significant difference in local recurrence rate and survival rate of patients undergoing endoscopic breast cancer conserving surgery,but more long-term follow-up studies are needed to further confirm it.

关 键 词：乳腺癌 腔镜手术 保乳手术 

分 类 号：R6[医药卫生—外科学]