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乳腺癌改良根治术的腋窝处理 被引量:2

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摘要 目的:通过对腋窝处理的改进,探讨乳腺癌改良根治术中,免除腋窝淋巴结清扫(ALND)并发症的可行性。方法:在ALND中保留肋间臂神经(ICBN),并作亚甲蓝示踪前哨淋巴结活检(SLNB)及洞式探查。结果:ICBN保留率97%(84/86),术后疼痛综合征(PMPS)发生率4.7%(4/86),随访3年2个月无局部复发和远处转移。SLBN检出率90.6%(78/86),准确率94.8%(74/78),假阴性率5.0%(4/78)。假阴性4例中,有3例被洞式探查证实为跳跃式转移所致。SLBN的转移阴性率35.8%(28/78)和阴性率64.2%(50/78),与ALN的阳性率38.4%(55/86)和阴性率61.6%(53/86),差异均无显著性意义(P>0.05)。结论:SLNB可以取代ALND,对区域淋巴结转移情况作出准确判断。SLNB阴性患者将不再清扫腋窝。洞式检查可修正SLNB的假阴性率,使其准确性进一步提高。需ALND者,术中常规保留ICBN可明显减少PMPS的发生。
出处 《中国社区医师(医学专业)》 2012年第11期108-109,共2页
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参考文献11

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