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目的探讨吸脂法腔镜腋窝淋巴结清扫的手术技术。方法分析采用吸脂法进行完全腔镜腋窝淋巴结清扫手术的45例患者的临床资料,并与传统开放手术进行比较。结果完全腔镜腋窝淋巴结清扫手术组清扫淋巴结8~34枚,平均18枚;腔镜腋窝淋巴结清扫手术时间为60~190min,平均108min,较传统手术时间长(P<0·05)。腔镜手术组出血量为80~220ml,平均152·82ml,明显少于常规手术组280·29ml(P<0·01)。腔镜手术组术后腋窝引流量为60~180ml,平均140·38ml,拔引流管时间6~15d,平均6·91d。术后皮下积液7例,皮肤表皮水疱5例,胸壁和上臂内侧蜂窝织炎2例。腔镜手术组在清扫腋窝淋巴结数目、术后引流量、引流时间、术后并发症等方面与常规开放性手术相比较无明显差异(P>0·05)。结论腔镜手术组手术切口相对较小,美容效果较好,患者比较满意。吸脂法腔镜腋窝淋巴结清扫可以达到常规手术的清扫范围,但技术有待进一步规范。
Objective To investigate the surgical technique of liposuction laparoscopic axillary lymph node dissection. Methods The clinical data of 45 patients undergoing total laparoscopic axillary lymph node dissection by liposuction were analyzed and compared with the conventional open surgery. Results The total lymph node dissection in axillary lymph node dissection group was 8 to 34, with an average of 18. The axillary lymph node dissection time was 60 to 190 minutes (average 108 minutes), which was longer than the conventional surgery (P <0.05). The amount of bleeding in the endoscopic surgery group was 80 ~ 220ml, with an average of 152.82ml, which was significantly lower than 280.29ml of the conventional operation group (P <0.01). The amount of axillary drainage in the endoscopic surgery group was 60 ~ 180ml, with an average of 140.38ml. The time of pulling the drainage tube was 6 ~ 15 days, an average of 6.91 days. Postoperative subcutaneous fluid in 7 cases, 5 cases of epidermal blisters, chest wall and upper arm inner cellulitis in 2 cases. There was no significant difference in the number of axillary lymph nodes dissection, postoperative drainage, drainage time and postoperative complications between the two groups (P> 0.05). Conclusions The surgical incision of laparoscopic surgery group is relatively small, the cosmetic effect is better, and the patients are satisfied. Liposuction laparoscopic axillary lymph node dissection can reach the scope of conventional surgical cleaning, but the technology needs further specification.