Clinical observation of two kinds of endoscopic axillary lymph node dissection for breast cancer

doi:10.3877/cma.j.issn.1674-3946.2023.03.013

Abstract

Abstract:

Objective

To investigate the short-term and long-term clinical effects of two kinds of endoscopic axillary lymph node dissection（MALND）for breast cancer.

Methods

A total of 108 patients with breast cancer admitted from September 2019 to December 2021 were selected as research objects. The patients were divided into lipid soluble group and non-lipid soluble group by random number table method，with 54 patients in each group. The fat soluble group was administered MALND by the fat soluble aeration method，and the non-fat soluble group was administered MALND by the non-fat soluble aeration method. SPSS 22.0 was used to process the data. Measurement data such as perioperative indicators were represented by（

x ˉ

±s）and independent sample t test was performed. Counting data such as postoperative complications were represented by［cases（%）］，and χ² tests were performed. Survival analysis was performed by Kaplan-Meier method and Log-Rank test. P<0.05 indicated statistically significant difference.

Results

The operation time of non-soluble lipid group was significantly higher than that of soluble lipid group（P<0.05）. There was no significant difference in intraoperative blood loss，number of lymph node dissection，postoperative drainage volume and postoperative hospital stay between the two groups（P>0.05）. There was no significant difference in the total incidence of postoperative complications between the two groups（16.7% vs.11.1%）（P>0.05）. The cumulative disease-free survival rate in non-soluble group was significantly higher than that in soluble group（94.4% vs.83.3%），and the difference was statistically significant（Log-Rank χ²=3.899，P=0.048）.

Conclusion

Both MALND and MALND are safe and feasible. Although the operation time of MALND is slightly prolonged，the non-soluble method does not increase the risk of operation，and is beneficial to improve the prognosis of patients，which is worthy of clinical promotion and application.

Key words: Breast Neoplasms, Mastoscopy, Neck Dissection, Liposuction, Non-Liposuction

Hao Wu, Haiming Duan, Kunpeng Gao, Xiaoni Lei. Clinical observation of two kinds of endoscopic axillary lymph node dissection for breast cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(03): 280-283.

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References 16

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组别	例	年龄 (岁)	BMI (kg/m²)	肿瘤位置
组别	例	年龄 (岁)	BMI (kg/m²)	A/B/C/D
溶脂组	54	49.6±8.8	22.9±2.7	26/11/10/7
非溶脂组	54	48.9±9.3	23.3±2.5	28/9/11/6
Z/t/χ²值		0.402	0.799	0.408
P值		0.344	0.213	0.939
组别	例	肿瘤直径(cm)	pTNM分期	病程 (月)
组别	例	肿瘤直径(cm)	Ⅰ/Ⅱ	病程 (月)
溶脂组	54	1.8±0.9	34/20	9.7±2.6
非溶脂组	54	1.9±0.8	36/18	10.2±2.4
Z/t/χ²值		0.610	0.162	1.038
P值		0.272	0.687	0.151

组别	例	年龄 (岁)	BMI (kg/m²)	肿瘤位置
组别	例	年龄 (岁)	BMI (kg/m²)	A/B/C/D
溶脂组	54	49.6±8.8	22.9±2.7	26/11/10/7
非溶脂组	54	48.9±9.3	23.3±2.5	28/9/11/6
Z/t/χ²值		0.402	0.799	0.408
P值		0.344	0.213	0.939
组别	例	肿瘤直径(cm)	pTNM分期	病程 (月)
组别	例	肿瘤直径(cm)	Ⅰ/Ⅱ	病程 (月)
溶脂组	54	1.8±0.9	34/20	9.7±2.6
非溶脂组	54	1.9±0.8	36/18	10.2±2.4
Z/t/χ²值		0.610	0.162	1.038
P值		0.272	0.687	0.151

组别	例	手术时间(min)	术中出血量(ml)		淋巴结清扫数目(枚)
溶脂组	54	92.4±23.3	32.4±9.3		16.6±3.2
非溶脂组	54	102.2±31.4	34.7±10.6		17.5±3.3
t值		1.842	1.199		1.439
P值		0.034	0.117		0.077
组别	例	术后引流量(ml)		术后住院时间(d)
溶脂组	54	201.9±61.7		11.2±3.1
非溶脂组	54	187.3±54.1		10.5±2.8
t值		1.307		1.231
P值		0.097		0.111

组别	例	手术时间(min)	术中出血量(ml)		淋巴结清扫数目(枚)
溶脂组	54	92.4±23.3	32.4±9.3		16.6±3.2
非溶脂组	54	102.2±31.4	34.7±10.6		17.5±3.3
t值		1.842	1.199		1.439
P值		0.034	0.117		0.077
组别	例	术后引流量(ml)		术后住院时间(d)
溶脂组	54	201.9±61.7		11.2±3.1
非溶脂组	54	187.3±54.1		10.5±2.8
t值		1.307		1.231
P值		0.097		0.111

组别	例	切口感染	皮下积液	提肩运动障碍
溶脂组	54	2(3.7)	1(1.9)	2(3.7)
非溶脂组	54	1(1.9)	0(0.0)	2(3.7)
χ²值		-	-	-
P值		-	-	-
组别	例	上臂麻木疼痛	上肢淋巴水肿	总并发症
溶脂组	54	3(5.6)	1(1.9)	9(16.7)
非溶脂组	54	2(3.7)	1(1.9)	6(11.1)
χ²值		-	-	0.697
P值		-	-	0.404

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