乳腺癌淋巴结清扫新术式的临床可行性研究

目的设计并临床验证乳腺癌腋窝及锁骨下逆行淋巴结清扫法的临床可行性；同时探索保乳手术的实施策略。方法对78例女性乳腺癌住院患者（42例施行保乳手术，36例施行改良根治术）采用逆行腋窝及锁骨下淋巴结清扫法进行引流区域的淋巴结清扫。结果78例均未出现神经、血管损伤等并发症，术后恢复顺利；随访3～29个月，未见1例复发和转移，也未发现上肢疼痛、肿胀等并发症。结论逆行腋淋巴结清扫法，对各组淋巴结显露清晰，能全面掌握区域淋巴结状况，操作简便易行，适用于各种保留胸肌或保乳的乳腺癌手术。

A Clinical Feasibility Study of New Lymph Node Dissection Method for Breast Cancer

Objective To design and clinically verify the feasibility of inverse lymph node dissection in fossa axillary and subclavicular. At the same time, to investigate the practical strategies of breast conservation therapy. Methods Of 78 in-patient breast cancer cases admitted 42 patients were received breast conservation therapy and the other 36 patients were received modified radical mastectomy. All the lymph nodes of drainage area were removed with inverse lymph node dissection method. Results There were no complications such as nerve and vessel damage in these 78 cases and their recovery was good. All of the patients have been following up for 3 to 29 months, without metastasis and recurrence observed, neither pain nor lymphedema of upper extremeties occurring. Conclusion The method of inverse lymph node dissection can clearly show lymph nodes in all groups, which helps us to master the conditions of regional lymph nodes. Furthermore, this method can be easily manipulated. It is suitable for multiplicate kinds of operation aimed at conserving pectoral muscle or breast during breast cancer operation.