新辅助化疗对腔镜乳腺癌改良根治术后并发症及疗效的影响梁全琨.docVIP

新辅助化疗对腔镜乳腺癌改良根治术后并发症 及疗效的影响 梁全琨，张永松，钟玲，范林军（400038重庆，第三军医大学西南医院乳腺中心） ［提要］ 目的 评估新辅助化疗对腔镜乳腺癌改良根治术后并发症及疗效的影响。方法 共纳入接受腔镜手术的乳腺癌患者183例，其中98例首先给予新辅助化疗（新辅助化疗组），85例立即行腔镜改良根治术治疗（对照组）。结果 两组手术时间、出血量、引流量无显著差异（p0.05）3.1%vs5.9%和8.2%vs12.9%），但两组无统计学差异（p0.05），两组在乳头或皮瓣坏死、局部复发、远处转移及死亡率方面也无显著差异（p0.05）。结论 新辅助化疗不会增加腔镜乳腺癌改良根治术后并发症的发生率，也不会影响患者的远期疗效。 ［关键词］ 新辅助化疗；腔镜；乳腺癌；并发症；疗效 Impact of neoadjuvant chemotherapy on postoperative complications and effectiveness after endoscopic mastectomy for breast cancer Liang Quankun,Zhang Yongsong,Zhong Ling,Fan Linjun(Department of Breast Center, Southwest Hospital,Third Military Medical University, Chongqing,400038,China) [Abstract] Objective To evaluate the impact of neoadjuvant chemotherapy (NCT) on postoperative complications and effectiveness after endoscopic mastectomy for breast cancer. Methods We retrospectively reviewed 183 patients with advanced breast cancers who underwent endoscopic mastectomy,98 of them receive neoad- juvant chemotherapy before surgeries(the NCT group),and 85 of them receive endo- scopic mastectomy immediately(the control group).Results There were no statistic difference between two groups in terms of operation times, amount of bleeding and drainage (p0.05). Rates of infection and edema of the upper extremity in NCT group were lower than which in the control group(3. 1%vs5.9% and 8.2%vs12. 9%),but there showed no statistic difference(p0.05). No statistic difference was observed between two groups in terms of necrosis of nipple or skin flap, local recurrence, distant metastasis and mortality rate as well(p0.05). Conclusion Neoadjuvant chemotherapy did not increase postoperative complications and influence the effect after endoscopic mastectomy for breast cancer. [Key words] neoadjuvant chemotherapy; endoscopic; breast cancer; complication; effect 乳腺癌已经跃升至女性恶性肿瘤发病率的第一位，且仍有逐年上升的趋势[1-2]。由于综合治疗水平的提高，乳腺癌总的生存率得到了明显的改善[3]。乳腺癌改良根治术作为乳腺癌的一种经典术式至今仍为广泛的应用，腔镜乳腺癌改良根治术的应用为乳腺癌患者提供了新的手术方式，其在保证相同手术效果的前提下避免在乳房表面留下明显的切口，可获得较传统开放手术更好的外观