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目的探讨乳腺癌保乳切除加经乳腔镜清扫腋窝淋巴结的可行性和手术难点。方法将2007年2月2011年2月行乳腺癌保乳切除手术的27例患者,分成乳腔镜腋窝清扫组(乳腔镜组)11例和常规腋窝清扫组(常规组)16例,比较两组患者手术时间、术中出血量、术中清扫淋巴结数、术后引流时间及引流量等。结果手术时间:乳腔镜组(186.36±11.20)min,常规组(158.13±25.29)min,两组差异有统计学意义(P=0.002);术中出血量:乳腔镜组(61.82±51.54)mL,常规组(103.75±42.56)mL,两组差异有统计学意义(P=0.030);两组术中清扫淋巴结个数、术后引流时间、引流量比较,差异均无统计学意义(P>0.05);随访1个月～4年,无一例发生肿瘤局部复发或戳孔转移。结论乳腺保乳切除加经乳腔镜清扫腋窝淋巴结可以安全应用于早期乳癌的保乳治疗,操作者需学习一定的手术技巧。
Objective To investigate the feasibility and difficulty of breast cancer excision plus laparoscopic axillary lymph node dissection. Methods Twenty-seven patients underwent breast-conserving surgery for breast cancer in February 2007 and February 2011 were divided into two groups: the laparoscopic axillary dissection group (n = 11) and the conventional axillary dissection group (n = 16) The operation time, intraoperative blood loss, the number of lymph nodes dissected, the drainage time and the drainage volume of the two groups were compared. Results The time of operation was (96.36 ± 11.20) min in the laparoscopic group and 158.13 ± 25.29 min in the conventional group (P = 0.002). The amount of bleeding during the operation was 61.82 ± 51.54 ) in the conventional group (103.75 ± 42.56) mL, the difference between the two groups was statistically significant (P = 0.030). There was no significant difference in the number of lymph nodes dissected between the two groups, drainage time and drainage volume P> 0.05); Followed up for 1 month to 4 years, no local recurrence of tumor or poke hole metastasis occurred. Conclusion Breast conserving excision plus laparoscopic axillary lymph node dissection can be safely applied to the breast-conserving treatment of early breast cancer. The operator needs to learn certain surgical skills.