目的

探讨临床Ⅰ、Ⅱ期乳腺癌腔镜腋窝淋巴结清扫术的可行性。

方法

本院2006年1月至2008年1月对临床Ⅰ、Ⅱ期乳腺癌患者行腔镜下腋窝淋巴结清扫术55例,同时选取传统腋窝淋巴结清扫术63例,对两组手术时间、出血量、淋巴结清扫数量、腋下引流液量及预后进行比较。定量资料的分析采用t检验;定性资料的比较用χ² 检验。

结果

腔镜手术组手术时间平均121.0 min,术中出血51.0 ml,平均每例清扫淋巴结数量17.3枚,术后总引流量平均208.0 ml,随访1～3年术后复发转移者2例;对照组手术时间平均70.0 min,术中出血平均80.0 ml,平均每例清扫淋巴结19.5枚,术后总引流量平均350.0 ml,术后复发转移者2例。腔镜手术组手术时间较传统手术长,但术中出血及术后引流液明显低于传统手术(P＜0.05)。两组间近期复发转移率比较,差异无统计学意义(χ²=0.02,P=0.89)。

结论

腔镜手术可以达到传统手术的治疗效果。

Objective

To study the clinical effect and technical feasibility of endoscopic axillary ly mph node dissection for stageⅠandⅡbreast cancer patients.

Methods

From January 2006 to January 2008,118 patients with stageⅠandⅡbreast cancer were treated with endoscopic axillary ly mph node dissection(the EALND group,n=55)and conventional axillary ly mph node dissection(the CALND group,n=63),respectively.The operation ti me,bleeding amount,nu mber of ly mph nodes dissected,axillary drainage amount and prognosis were compared bet ween the t wo groups.Student's t test and Chisquare test were used for statistical analysis.

Results

In the EALND group,the mean operation ti me was 121.0 minutes,the intraoperative bleeding amount was 51.0 ml,the mean nu mber of ly mph nodes dissected was 17.3,the total postoperative axillary drainage was 208.0 ml;the follow-up of 1-3 years showed 2 patients had recurrence and metastasis.In the CALND group,the mean operation ti me was 70.0 minutes,the intraoperative bleeding amount was 80.0 ml,the mean number of ly mph nodes harvested was 19.5,the total postoperative axillary drainage was 350.0 ml;and postoperative recurrence and metastasis were in 2 patients.The operation ti me was longer in the EALND group than in the CALND group,but the intraoperative bleeding and postoperative drainage of the EALND group were significantly less than those of the CALND group(P＜0.05);short term outcome had no significant difference between the two groups(χ²=0.02,P=0.89).

Conclusion

Endoscopic axillary lymph node dissection can obtain similar therapeutic effect with conventional techniques.