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目的:探讨腔镜腋窝淋巴结清扫治疗早期乳腺癌保乳手术的可行性及临床效果。方法:回顾分析98例早期乳腺癌行保乳手术的临床资料,其中41例行腔镜腋窝淋巴结清扫术(腔镜组),57例行常规腋窝淋巴结清扫术(常规组),比较两组手术时间、出血量、清扫淋巴结个数、阳性淋巴结数及并发症、预后等。结果:两组均完成手术。腔镜组与常规组平均手术时间分别为99.5 min与61.5 min(P<0.05),平均清扫出腋窝淋巴结数分别为17.6枚与18.6枚(P>0.05),平均阳性淋巴结数分别为2.1枚与2.4枚(P>0.05),平均手术出血量分别为35.4 mL与61.5 mL(P<0.05)。随访1～4年,腔镜组无复发及转移病例,未出现术后并发症。常规组1例出现患侧上肢水肿,1例乳房皮肤瘢痕愈合不良;1例乳房局部复发,1例肺转移,1例胫骨转移。两组均无死亡病例。结论:腔镜腋窝淋巴结清扫术与开放腋窝淋巴结清扫术同样能彻底完成腋窝淋巴结清扫,具有并发症少,美学效果好的优势。
Objective: To investigate the feasibility and clinical effect of laparoscopic axillary lymph node dissection in breast-conserving surgery of early breast cancer. Methods: A retrospective analysis of 98 cases of breast cancer breast conserving surgery clinical data, 41 cases of laparoscopic axillary lymph node dissection (endoscopic group), 57 cases of conventional axillary lymph node dissection (conventional group), the two groups were compared Time, amount of bleeding, the number of lymph nodes, positive lymph nodes and complications, prognosis and so on. Results: Both groups completed the operation. The average operation time of laparoscopic group and conventional group were 99.5 min and 61.5 min (P <0.05). The average number of axillary lymph nodes dissected out was 17.6 and 18.6 (P> 0.05) respectively. The mean number of positive lymph nodes was 2.1 and 2.4 (P> 0.05). The mean operative blood loss was 35.4 mL and 61.5 mL, respectively (P <0.05). Follow-up 1 to 4 years, no recurrence and metastasis cases of endoscopic group, no postoperative complications. In the conventional group, ipsilateral upper limb edema occurred in one case, and one case had scar healing of breast skin. One case had local recurrence of breast, one case of pulmonary metastasis and one case of tibial metastasis. No deaths were reported in both groups. Conclusion: Axillary axillary lymph node dissection and axillary lymph node dissection open axillary lymph node dissection can be completely completed, with fewer complications, the advantages of good aesthetic effect.