腋窝入路非溶脂充气法腔镜保乳术+前哨淋巴结活检治疗cN0乳腺癌的效果分析OA
Therapeutic effect analysis of axillary approach non-lipolytic insufflation endoscopic breast-conserving surgery combined with sentinel lymph node biopsy for cN0 breast cancer
目的:探讨经腋窝入路非溶脂充气法腔镜保乳术+前哨淋巴结活检(SLNB)治疗 cN0 乳腺癌的效果.方法:回顾分析 2020 年 1 月至 2023 年 12 月手术治疗的 92 例 cN0 乳腺癌患者的临床资料,接受腋窝入路非溶脂充气法腔镜保乳术+SL-NB 的患者纳入 A 组,接受开放保乳术+SLNB 的患者纳入 B 组,每组 46 例.比较两组手术相关指标及术后 6 个月乳房美容效果,观察两组术前与术后6 个月上肢活动度、生活质量变化情况及术后并发症.结果:A 组切口长度、住院时间短于 B 组,手术时间长于 B 组(P<0.05).术后 6 个月,A 组乳房美容效果优良率高于 B 组(P<0.05);两组上肢活动度均缩小,A 组大于 B 组(P<0.05);两组乳腺癌患者生命质量测定量表评分均升高,A 组高于 B 组(P<0.05).术后两组并发症发生率差异无统计学意义(P>0.05).结论:与开放保乳术联合 SLNB 相比,腋窝入路非溶脂充气法腔镜保乳术联合 SLNB 治疗 cN0 乳腺癌虽然手术时间较长,但在乳房美容效果、上肢功能保留方面的优势更加突出,利于促进术后康复、提高生活质量.
Objective:To investigate the efficacy of axillary approach non-lipolytic insufflation endoscopic breast-conserving surgery combined with sentinel lymph node biopsy(SLNB)in the treatment of cN0 breast cancer.Methods:The clinical data of 92 pa-tients with cN0 breast cancer who underwent surgical treatment from Jan.2020 to Dec.2023 were retrospectively analyzed.Patients who underwent endoscopic breast-conserving surgery via the axillary approach using a non-lipolytic insufflation technique combined with SL-NB were assigned to group A,and those who underwent open breast-conserving surgery combined with SLNB were assigned to group B,with 46 patients in each group.Surgery-related indicators and breast cosmetic effect 6 months after surgery were compared between the two groups.Changes in upper limb range of motion and quality of life before surgery and 6 months after surgery,and postoperative com-plications were observed in both groups.Results:The incision length and hospital stay in group A were shorter than those in group B,while the operation time was longer than that in group B(P<0.05).6 months after operation,the excellent and good rate of breast cos-metic effect in group A was higher than that in group B(P<0.05);the upper limb range of motion in both groups decreased,but that in group A was greater than that in group B(P<0.05);the scores of the functional assessment of cancer therapy-breast in both groups in-creased,and that in group A was higher than that in group B(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions:Compared with open breast-conserving surgery combined with SLNB,axillary approach non-lipolytic insufflation endoscopic breast-conserving surgery combined with SLNB for cN0 breast cancer requires a longer operation time,but offers more prominent advantages in breast cosmetic effect and upper limb function preservation,which is conducive to promoting postoperative recovery and improving quality of life.
袁成龙;刘朋宙;陈鑫娴;李海鹏;吴国庆
北京市怀柔区中医医院外科,北京,101499北京市怀柔区中医医院外科,北京,101499北京市怀柔区中医医院外科,北京,101499北京市怀柔区中医医院中医肿瘤内科北京市怀柔区中医医院外科,北京,101499
医药卫生
乳腺肿瘤保乳手术内窥镜检查经腋窝入路前哨淋巴结活检美容效果上肢活动度
Breast neoplasmsBreast-conserving surgeryEndoscopyAxillary approachSentinel lymph node biopsyCosmetic effectUpper limb range of motion
《腹腔镜外科杂志》 2026 (5)
321-326,332,7
首都卫生发展科研专项立项项目(首发2024-2-4025)
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