中国医科大学学报2024,Vol.53Issue(8) :692-696,703.DOI:10.12007/j.issn.0258-4646.2024.08.004

腋窝淋巴结手术对全乳房切除术联合即刻两期法乳房再造患者术后并发症的影响

Effect of axillary lymph node surgery on complications following immediate two-stage breast reconstruction after mastectomy

李玲 陈波 韩思源
中国医科大学学报2024,Vol.53Issue(8) :692-696,703.DOI:10.12007/j.issn.0258-4646.2024.08.004

腋窝淋巴结手术对全乳房切除术联合即刻两期法乳房再造患者术后并发症的影响

Effect of axillary lymph node surgery on complications following immediate two-stage breast reconstruction after mastectomy

李玲 1陈波 1韩思源1
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作者信息

  • 1. 中国医科大学附属第一医院乳腺外科,沈阳 110001
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摘要

目的 比较不同术式的腋窝淋巴结手术对全乳房切除术联合即刻两期法乳房再造患者术后并发症的影响.方法 收集2018年 1月至2021年12月中国医科大学附属第一医院乳腺外科232例采用全乳房切除术联合即刻两期法乳房再造患者的临床资料.根据腋窝淋巴结手术方式分为前哨淋巴结活检组(SLNB组,n=84)和腋下淋巴结清扫术组(ALND组,n=148).比较2组患者各项临床指标、术后并发症及预后情况.结果 与SLNB组比较,ALND组患者T分期和N分期更高,接受新辅助化疗、化疗、放疗比例更高,术后总引流量更多,术后并发症发生率更高,差异均有统计学意义(均P<0.05).而2组患者局部/区域复发率、远处转移率,无病生存期比较差异均无统计学意义(均P>0.05).结论 全乳房切除术联合即刻两期法乳房再造术中,与前哨淋巴结活检比较,腋下淋巴结清扫术患者术后并发症发生率更高.

Abstract

Objective To compare the effects of different axillary lymph node surgical procedures on complications following immediate two-stage breast reconstruction after mastectomy.Methods A retrospective analysis was performed on 232 patients who underwent mas-tectomy with immediate two-stage breast reconstruction in the Department of Breast Surgery at the First Hospital of China Medical Uni-versity between January 2018 and December 2021.Patients were divided into two groups based on the type of axillary lymph node surgery performed:the sentinel lymph node biopsy group(SLNB group,n=84)and the axillary lymph node dissection group(ALND group,n=148).We compared baseline characteristics,surgical procedures,and postoperative complications between the two groups.Results The ALND group had a higher prevalence of advanced T and N stages,received neoadjuvant chemotherapy more frequently,and underwent chemotherapy and radiotherapy at a higher rate compared to the SLNB group.Additionally,the ALND group experienced greater drainage volume and a significantly higher complication rate(all P<0.05).Postoperative infection was the most common complication observed in the ALND group.Importantly,no significant differences were found in long-term outcomes(local/regional recurrence,distant metastasis,and disease-free survival)between the two groups(all P>0.05).Conclusion In patients undergoing immediate two-stage breast recon-struction after mastectomy,axillary lymph node dissection is associated with a higher rate of reconstruction complications compared to sentinel lymph node biopsy.

关键词

腋窝淋巴结手术/全乳房切除术/即刻两期法乳房再造/并发症

Key words

axillary lymph node surgery/mastectomy/immediate two-stage breast reconstruction/complication

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基金项目

辽宁省科学技术计划(203JH2/101300048)

出版年

2024
中国医科大学学报
中国医科大学

中国医科大学学报

CSTPCD北大核心
影响因子:1.421
ISSN:0258-4646
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