腔镜乳腺癌腋窝淋巴结清扫术要点与难点  

Key and difficult points of endoscopic axillary lymph node dissection in breast cancer

作　　者：刘绮雯 李宗晏 李海燕[1,2] LIU Qi-wen;LI Zong-yan;LI Hai-yan(Department of General Surgery(Breast Surgery),the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,510000,China;Biomedical Innovation Center,the Sixth Affiliated Hospital,Sun Yat-sen University)

机构地区：[1]中山大学附属第六医院普通外科(乳腺外科),广东广州510000 [2]广州市黄埔区中六生物医学创新研究院,广东广州510000

出　　处：《中国实用外科杂志》2024年第11期1238-1242,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金青年项目(No.81602331);广东省自然科学基金项目(No.2020A1515010424)。

摘　　要：腋窝淋巴结清扫术是乳腺癌评估临床分期和判断预后中至关重要的步骤。传统开放手术损伤大,容易破坏解剖微结构,增加术后并发症的风险。腔镜技术作为微创手术代表性技术之一,具备精准、微创和保护功能的特点,为解决乳腺癌外科治疗难题提供了新思路,在保证手术安全、根治的前提下保护微结构并减少并发症的发生风险。由于乳腺外科腔镜技术起步相对较晚,腔镜乳腺癌腋窝淋巴结清扫术的操作技术尚需要更多的关注和思考。利用CO_(2)的气化作用代替传统拉钩,辨认解剖层面,分离和清扫顺序正确等均为腔镜乳腺癌腋窝淋巴结清扫术需要注意的技术重点与难点。The axillary lymph node dissection is a critical step in the clinical staging and prognosis assessment of breast cancer.Traditional open surgery results in large incisions,which can easily damage microstructures and increase the risk of postoperative complications.Endoscopic technology,as a representative minimally invasive technique,offers precision,minimal invasiveness,and protective functions,providing a novel approach to address challenges in surgical treatment for breast cancer by ensuring surgical safety and efficacy while safeguarding microstructures and reducing complications.Given the relatively recent adoption of endoscopic technology in breast surgery,greater attention and consideration are required for the operative technique of endoscopic axillary lymph node dissection in breast cancer.Using carbon dioxide gasification instead of traditional hooks,identifying anatomical planes,and performing endoscopic axillary lymph node dissection in breast cancer according to correct separation and clearance sequence are the key points and difficulties of endoscopic axillary lymph node dissection in breast cancer.

关 键 词：乳腺癌 腔镜技术 腋窝淋巴结清扫术 膜解剖 质量控制 

分 类 号：R6[医药卫生—外科学]