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目的探讨乳腺癌改良根治术Ⅰ式的临床疗效。方法回顾性分析325例乳腺癌改良根治术Ⅰ式的临床资料。结果术中淋巴结清扫数目为7～18枚,平均13.6枚。术后皮下积液35例(10.8%),皮瓣坏死49例(15.1%)。术后行放、化疗和内分泌治疗等285例,占87.7%(放化疗97例,单纯化疗167例,单纯放疗13例,单纯内分泌治疗8例);术后未行正规综合治疗40例。手术及综合治疗组3年生存率84.2%(240/285),5年生存率66.3%(189/285);未行正规综合治疗组3年生存率72.5%(29/40),5年生存率35.0%(14/40),2组3、5年生存率及3、5年复发率差异均有统计学意义(P均<0.05)。结论乳腺癌改良根治术(Ⅰ式)术中适时变换体位,注意操作技巧,可以保证清扫范围,降低术后皮下积液等并发症的发生,术后进行综合治疗,可以降低患者的医疗风险,提高患者的生存率。
Objective To investigate the clinical efficacy of modified radical mastectomy for breast cancer. Methods A retrospective analysis of 325 cases of modified radical mastectomy type Ⅰ clinical data. Results The number of lymph nodes in operation was 7-18, with an average of 13.6. Subcutaneous fluid in 35 cases (10.8%), flaps necrosis in 49 cases (15.1%). There were 285 cases (87.7%) after radical radiotherapy, chemotherapy and endocrine therapy (97 radiotherapy and chemotherapy, 167 chemotherapy alone, 13 radiotherapy alone and 8 endocrine therapy alone). The 3-year survival rate was 84.2% (240/285) in the operation and comprehensive treatment group, and the 5-year survival rate was 66.3% (189/285). The 3-year survival rate was 72.5% (29/40) The 35.5% (14/40) rate of 2, 3 and 5 year survival rates and the recurrence rates at 3 and 5 years were significantly different (all P <0.05). Conclusions Modified radical mastectomy for breast cancer can timely change position and pay attention to operation skills to ensure the scope of the operation and reduce complications such as subcutaneous fluid accumulation after operation. Comprehensive treatment after operation can reduce the medical risk of patients, Improve patient’s survival rate.