保留肋间臂神经的乳腺癌根治术前瞻性研究

目的 探讨乳腺癌根治术中保留肋间臂神经(ICBN)的临床意义.方法 收集Ⅰ～Ⅲa期乳腺癌患者140例,其中试验组79例行保留ICBN的乳腺癌根治术,对照组61例行常规乳腺癌根治术.对两组患者术后的局部复发及感觉障碍情况进行对比分析.结果 试验组(7例剔除,1例术后失访)与对照组(2例术后失访)术后1～5年局部复发率分别为0～4.2%(3/71)和0～3.4%(2/59),差异无统计学意义(P＞0.05);试验组术后1～24个月局部感觉障碍发生率[2.8%(2/71)～11.3%(8/71)]明显低于对照组[54.2%(32/59)～71.2%(42/59)],差异有统计学意义(P＜0.01).结论 保留ICBN的乳腺癌根治术是乳腺癌根治性切除的理想术式.

Prospective study of radical resection of breast cancer with preservation of intercostobrachial nerve

Objective To explore the clinical significance of preserving the intercostobrachial nerve (ICBN) in the radical resection of breast cancer. Method All of 140 cases of breast cancer with Ⅰ - Ⅲ a stage operable eligible,were randomly divided into the experimental group with 79 cases (7 cases were rejected, 1 case was lost) that patients received radical resection of breast cancer with preservation of ICBN,and the control group with 61 cases (2 cases were lost) that patients received routine radical resection of breast cancer based on the time of admission. Analyzed postoperative local recurrence and compared to sensory dysfunction of the two groups. Results There was no significant difference between the two groups of patients in the rate of postoperative local recurrence [0-4.2% ( 3/71 ) vs. 0-3.4% (2/59)] ( P ＞ 0.05 ). The local sensory disturbance of the experimental group [2.8% (2/71 )-11.3% (8/71)] was significantly lower than the control group [54.2%(32/59)-71.2%(42/59)], there was significant difference between the two groups (P ＜ 0.01 ). Conclusion Radical resection of breast cancer with preservation of ICBN is an ideal operation in breast cancer.