关键词: 乳腺癌, 内腔镜, 腋窝淋巴结清扫

Abstract: Objective To evaluate the feasibility and clinical outcome of endoscopic axillary lymph node dissection with liposuction(E-ALND) in 56 patients with breast cancer.Methods From October 2005 to February 2007,A total of 56 patients with breast cancer were treated with E-ALND.The clinical data of the patients were analyzed retrospectively and compared with those of 37 patients who had undergone traditional axillary lymph node dissection(T-ALND)during the same period.Results For patients with breast cancer stageⅠand Ⅱ E-ALND(n=56) and T-ALND(n=37) were performed.No case in E-ALND group had been converted to T-ALND,and no incidental injury and subcutaneous emphysema or fat emboli were encountered.There was no significant difference between the two groups in term of the number of resected lymph nodes,the total volume and duration of drainage.However,the blood loss,length of incision and operating time in E-ALND group were significantly reduced as compared with those in T-ALND group(128.1±24.0 mL vs 194.8±59.1 mL,P<0.01;12.9±1.3 cm vs 18.9±1.8 cm,P<0.01 and 96.3±24.3 min vs 80.6±14.4 min,P<0.01 respectively).Median follow-up for the 56 patients was 15.7 months ranging from 12 to 27 months.No wound infection was observed.Two patients had developed numbness and pain in the upper arm and 1 restriction of the shoulder motion in the E-ALND group,which were much lower than those in the T-ALND group(3.6% vs 24% and 1.8 vs 16.2%,P<0.05 respectively).No axillary recurrence and port-site metastases were noticed.Conclusion E-ALND technique is feasible and safe in selected patients with breast cancer,compared with the T-ALND.Furthermore,it requires a smaller incision and has better cosmetic effect and minor morbidity.However,the impact of the procedure on oncology needs to be further verified.

Key words: breast cancer, endoscopic surgery, axillary lymph node dissection