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目的:通过与改良根治术比较,探讨乳腺癌保乳手术的临床疗效。方法:回顾性分析广西医科大学第九附属医院自2001年9月—2006年9月早期乳腺癌患者196例,其中实施保乳手术96例,改良根治术100例,并对两者的临床资料进行研究,对比两组的切口长度、术中出血量、手术时间、术后住院天数、美容效果满意率、术后并发症及远期生存率。结果:保乳组切口长度、术后住院天数、手术时间、术中出血量、明显小(少)于改良组(P<0.01),美容效果满意率明显高于改良组(P<0.01);两组的生存率差异无统计学意义(P>0.05);保乳组术后发生3例皮下积液,改良组发生6例并有4例发生皮瓣坏死。中位随访时间61个月。两组5年的无病生存率分别为94%和96%,局部复发率分别为2%和1%。结论:早期乳腺癌行保乳治疗是安全可靠的,但必须掌握保乳手术指征并保证术后综合治疗。
Objective: To compare the curative effect of breast-conserving breast cancer surgery with modified radical mastectomy. Methods: Retrospective analysis of 196 patients with breast cancer at the ninth affiliated hospital of Guangxi Medical University from September 2001 to September 2006. Among them, 96 cases of breast-conserving surgery and 100 cases of modified radical mastectomy were reviewed. A study was conducted to compare incision length, intraoperative blood loss, operative time, postoperative hospital stay, satisfaction of cosmetic results, postoperative complications, and long-term survival. RESULTS: The length of incision, postoperative hospital stay, operation time, intraoperative blood loss, significantly less (less) in the modified group (P<0.01), satisfaction rate of cosmetic results in the breast-protecting group were significantly higher than those in the modified group (P<0.01). There was no significant difference in the survival rate between the two groups (P>0.05); 3 cases had subcutaneous fluid accumulation in the breast-conserving group, 6 cases occurred in the modified group, and 4 cases had flap necrosis. The median follow-up time was 61 months. The 5-year disease-free survival rates in the two groups were 94% and 96%, respectively, and the local recurrence rates were 2% and 1%, respectively. Conclusion: Breast-conserving treatment for early stage breast cancer is safe and reliable, but it is necessary to grasp the indications of breast-conserving surgery and ensure postoperative comprehensive treatment.