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目的:探讨乳腺癌Auchincloss-madden术式下锁骨下淋巴结(Ⅲ组淋巴结)清扫的方法及意义。方法:收集34例采取Auchincloss-madden术式下行Ⅲ组淋巴结清扫治疗的乳腺癌患者进行回顾性分析。结果:共清扫出82枚Ⅲ组淋巴结,有1例锁骨下淋巴脂肪组织内未找到淋巴结。33例中每例查见Ⅲ组淋巴结为1～5枚,平均为2.5枚。33例中13例既有Ⅰ、Ⅱ组淋巴结转移,又有Ⅲ组淋巴结转移;11例有Ⅰ、Ⅱ组淋巴结转移,而无Ⅲ组淋巴结转移;9例无腋窝淋巴结转移:未见有Ⅲ组淋巴结转移而无Ⅰ、Ⅱ组淋巴结转移的病例。结论:对于术前临床检查或术中发现Ⅲ组淋巴结肿大的病例清扫这组淋巴结是非常必要的,有助于病情精确分期,经过胸大、小肌间隙有助于清扫。
Objective: To investigate the method and significance of Auchincloss-madden operative subclavian lymph node dissection (group Ⅲ). Methods: A retrospective analysis was performed on 34 cases of breast cancer who underwent Auchincloss-madden operation with lymph node dissection. Results: A total of 82 Ⅲ lymph nodes were dissected, and 1 lymph node was not found in the subclavian fat tissue. 33 cases of each group found in group Ⅲ lymph nodes 1-5, with an average of 2.5. Of the 33 cases, there were 13 cases of lymph node metastasis in group Ⅰ and Ⅱ, and Ⅲ group of lymph node metastasis in 11 cases. There were 11 cases of lymph node metastasis in group Ⅰ and Ⅱ, but no lymph node metastasis in group Ⅲ. No axillary lymph node metastasis in 9 cases: Lymph node metastasis without Ⅰ, Ⅱ cases of lymph node metastasis. Conclusion: It is necessary to clean the group of lymph nodes in preoperative clinical examination or intraoperative findings of group Ⅲ lymph node enlargement, which is helpful for accurate staging of the disease.