乳腺癌Ⅲ组淋巴结清扫的价值和临床实践

    Value of level Ⅲ lymph node dissection for breast cancer and its clinical application

    • 摘要: 目的:探讨乳腺癌Ⅲ组淋巴结清扫的价值和手术技巧。方法:78例乳腺癌患者中,38例通过Kodama法(经肌间沟法)行Ⅰ~Ⅲ组淋巴结清扫,40例通过Auchincloss法(改良根治术法)行Ⅰ~Ⅱ组淋巴结清扫,对两组术后并发症进行比较性分析。结果:Kodama手术的Ⅰ~Ⅱ组腋窝淋巴结阳性中Ⅲ组淋巴结阳性率为25%;两种手术方法除手术时间差异有统计学意义(P<0.01)外,皮瓣坏死、淋巴瘘和胸大肌萎缩等术后并发症均无明显不同(P>0.05)。结论:对于Ⅰ~Ⅱ组腋窝有淋巴结转移者Ⅲ组淋巴结清扫是合理的;Kodama法清扫Ⅲ组淋巴结是一种值得推荐的术式。

       

      Abstract: Objective: To explore the value of dissection of level Ⅲ lymph nodes for breast cancers and the operation skills.Methods: The Kodama was used to dissect level Ⅰ-Ⅲ axillary lymph nodes of 38 patients with breast cancer and the Auchincloss was used to dissect level Ⅰ-Ⅱ axillary lymph nodes of 40 patients with breast cancer.The postoperative complications were analyzed comparatively.Results: The metastasis rate of level Ⅲ axillary lymph nodes was 25 percent in patients with level Ⅰ-Ⅱ axillary node metastasis.There was no difference in surgical complications(skin flap necrosis,lymph fistula and pectoralis major atrophy) (P>0.05),but the difference was significant in operation time(P<0.01).Conclusions: It is reasonable to dissect level Ⅲ axillary lymph nodes for the patients with levelⅠ-Ⅱ axillary node metastasis.The Kodama is a recommendable method for dissection of level Ⅲ axillary lymph nodes.

       

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