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目的探讨乳腔镜腋窝淋巴结清扫术的治疗效果及其优缺点。方法通过对同时期内80例早期乳腺癌行乳腔镜腋窝淋巴结清扫术和70例行传统腋窝淋巴结清扫术患者的临床资料及其随访结果进行统计分析,比较两种术式的手术时间、术中出血量、淋巴结清扫数目、腋窝引流时间、引流量、平均住院费用、术后上肢水肿、感觉异常、肩关节活动障碍、复发转移等方面的差异。结果乳腔镜腋窝淋巴结清扫术组手术时间要明显长于传统腋窝淋巴结清扫术组(P<0.05),但其术中出血量少(P<0.05),淋巴结清扫数目、腋窝引流时间与传统术式基本相当(P>0.05),术后引流量明显少于传统术式组(P<0.05),而平均住院费用则要高于传统术式组(P<0.05)。随访结果显示,乳腔镜腋窝淋巴结清扫术组术后上肢水肿、感觉异常、肩关节活动障碍等并发症明显少于传统腋窝淋巴结清扫术组(P<0.05),而两组肿瘤复发转移间差异无统计学意义(P>0.05)。结论乳腔镜腋窝淋巴结清扫术能达到传统腋窝淋巴结清扫术同样的治疗效果,并且其创伤小,术后并发症少,提高了乳腺癌患者术后的生存质量,值得临床推广。
Objective To investigate the treatment effect and advantages and disadvantages of laparoscopic axillary lymph node dissection. Methods 80 cases of early breast cancer during the same period undergoing laparoscopic axillary lymph node dissection and 70 cases of traditional axillary lymph node dissection in patients with clinical data and follow-up results were statistically analyzed, compared the two surgical procedures, surgery The amount of bleeding, the number of lymph node dissection, axillary drainage time, drainage volume, the average hospitalization costs, postoperative upper limb edema, sensory abnormalities, shoulder joint movement disorders, recurrence and metastasis differences. Results The operation time of laparoscopic axillary lymph node dissection group was significantly longer than that of traditional axillary lymph node dissection group (P <0.05), but the intraoperative blood loss was less (P <0.05). The number of lymph node dissection and armpit drainage time were significantly lower than those of conventional operation (P> 0.05). The postoperative drainage volume was significantly less than that of the traditional operation group (P <0.05), while the average hospitalization cost was higher than that of the traditional operation group (P <0.05). The follow-up results showed that postoperative complications of upper extremity edema, sensory abnormalities and shoulder joint mobility were significantly less in the axillary lymphadenectomy group than those in the traditional axillary lymph node dissection group (P <0.05), but there was no significant difference between the two groups No statistical significance (P> 0.05). Conclusions The laparoscopic axillary lymph node dissection can achieve the same therapeutic effect as the traditional axillary lymph node dissection. It has less trauma and less postoperative complications, and improves the quality of life of breast cancer patients after operation, which is worthy of clinical promotion.