超声刀在乳腺癌新辅助化疗后改良根治术中的应用价值

目的探讨在乳腺癌患者新辅助化疗后应用超声刀（UAS）的价值。方法回顾性分析福建医科大学附属龙岩第一医院，2009年6月至2011年8月收治的经新辅助化疗2～3周期后再行改良根治术的52例乳腺癌，其中UAS手术治疗组23例，电刀（EI）手术治疗组29例，比较2组手术时问、术中出血量、术后引流管留置时间、术后住院天数、淋巴结检出数及皮下积液的区别。结果UAS组与EI组相比，术中出血量、术后引流管留置时间差异均有高度统计学意义（P〈0．01）；手术时间、住院天数和皮下积液差异有统计学意义（P〈0．05）；淋巴结检出数差异无统计学意义（P〉0．05）。结论乳腺癌患者新辅助化疗后，应用UAS行改良根治术及腋窝淋巴结清扫效果好，符合快速康复外科理念。

The use of ultrasonically activated scalpel in modified radical mastectomy for breast cancer after neo-adjuvant chemotherapy

Objective To discuss the clinical value of ultrasonically activated scalpel （UAS）in breast cancer patients who underwent 2-3 cycles of neo-adjuvant chemotherapy by comparing UAS and electric knives （EI） in modified radical masteetomy. Methods From Jun. 2009 to Aug. 2011, 52 breast cancer patients tak- ing 2-3 cycles of neo-adjuvant chemotherapy underwent modified radical mastectomy in our hospital. Among them, UAS group included 23 patients, and EI group included 29 patients. The 2 groups were compared in terms of the operation time, intraoperative blood loss, postoperative drainage tube duration, postoperative hospital stay, the number of lymph nodes retrieved, and the volume of subcutaneous hydrops. Results Between the 2 groups, the difference of intraoperative blood loss and postoperative drainage tube duration had statistical significance （ P 〈 0. O1 ）. The difference of operation time, hospital stay, and subcutaneous hydrops had statistical significance （ P 〈 0. 05 ）. The difference of the number of lymph nodes retrieved had no statistical significance （ P 〉 0. 05 ）. Conclusion There are good curative effects for breast cancer patients undergoing modified radical mastectomy by UAS and axillary lymph node dissection after neo-adjuvant chemotherapy, which is consistent with the conception of fast track surgery.