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目的观察腔镜辅助小切口乳腺癌改良根治术的近期疗效。方法2003年10月至2005年2月对47例0~Ⅱ期(AJCC)乳腺癌病人施行腔镜辅助小切口乳腺癌改良根治术,并与既往相同分期的乳腺癌行传统改良根治术进行比较。结果手术保留乳头乳晕复合体35例,切除乳头乳晕复合体12例。胸壁切口长度(9.07±1.57)cm(6.0~11.5 cm),手术时间(259.91±48.27)m in(180~360m in),术中出血量(201.52±46.65)mL(130~280mL),术后引流量(134.82±49.68)mL(60~230mL),引流时间(7.00±2.40)d(5~11d),清扫腋窝淋巴结数目(14.82±5.03)枚(15~26枚)。与既往32例相同分期乳腺癌实施传统改良根治术相比,腔镜手术组手术时间稍长,清扫腋窝淋巴结数目、术后引流量和引流时间及术后并发症发生率差异无显著性,术中出血量明显减少,切口明显缩小,美容效果良好。平均随访10.5个月,无局部复发和远处转移。结论腔镜辅助小切口乳腺癌改良根治术为Ⅰ、Ⅱ期乳腺癌病人的手术治疗提供了新的术式,有利于乳房重建。
Objective To observe the short-term curative effect of modified radical mastectomy with endoscopic assisted small incision breast cancer. Methods From October 2003 to February 2005, 47 patients with stage 0 ~ Ⅱ (AJCC) breast cancer underwent modified radical mastectomy with minimally invasive endoscopic microsurgery and compared with the conventional modified radical mastectomy for the same stage of breast cancer . Results Surgical preservation of nipple areola complex in 35 cases, removal of nipple areola complex in 12 cases. The length of chest wall incision was (9.07 ± 1.57) cm (6.0-11.5 cm), the operation time was (259.91 ± 48.27) mm (180-360min), the amount of blood loss was (201.52 ± 46.65) mL The drainage volume (134.82 ± 49.68) mL (60-230 mL), drainage time (7.00 ± 2.40) d (5-11 days), and the number of axillary lymph nodes (14.82 ± 5.03) (15-26) were clear. Compared with the conventional modified radical mastectomy in 32 cases of the same stage of breast cancer, the operation time of the endoscopic surgery group was longer, the number of axillary lymph nodes dissection, postoperative drainage and drainage time and the incidence of postoperative complications was not significant Significantly reduce the amount of bleeding, incision significantly reduced, the cosmetic effect is good. The average follow-up of 10.5 months, no local recurrence and distant metastasis. Conclusion Endoscopic assisted small incision modified radical mastectomy provides a new surgical procedure for patients with stage Ⅰ and Ⅱ breast cancer, which is good for breast reconstruction.