乳癌腋淋巴结清扫术中保留肋间臂神经的临床意义

目的 探讨保留肋间臂神经在乳腺癌腋淋巴结清扫术中的可行性及临床价值.方法 在85例乳癌腋淋巴结清扫中施行保留肋间臂神经术,其中完整保留肋间臂神经56例,保留肋间臂神经上支5例,切除肋间臂神经22例.术后对病人进行观察并随访.结果 保留肋间臂神经56例中术后患侧上臂内侧及腋部皮肤感觉正常53例(94.6%),感觉异常3例(5.4%);切除肋间臂神经的22例病人术后均有患侧上臂内侧及腋部皮肤感觉异常.肋间臂神经缺如2例.随访1～4年85例均未见局部复发.结论 在乳腺癌腋淋巴结清扫术中保留肋间臂神经是可行的,它保留了患侧上臂内侧及腋部皮肤的感觉功能,改善了病人术后的生活质量,具有较好的临床价值.

Effect of preserving intercostobrachial nerve during axillary lymph node dissection for breast cancer

Objective To evaluate the feasibility and clinical value of preserving intercostobrachial nerve(ICBN) during axillary lymph node dissection for breast cancer. Methods Preservation of ICBN during axillary lymph node dissection was performed in 85 patients with breast cancer . ICBN was preserved completely in 56 cases, resected in 22 cases. All patients were followed up for 1-4 years after operations. Results Among the 56 patients with preservation of ICBN, 53 patients(94. 6%) had normal sensation of the skin of upper medial arm and axilla, paresthesia occurred in only 3 cases (5. 4%); while all the 22 patients with ICBN resected had paresthesia. ICBN was vacant in 2 cases. There was no local recurrence in any patient within the period of following up. Conclusion It is feasible to preserve ICBN during axillary lymph node dissection for breast carcer. It keeps the normal sensory functions of the skin of upper medial arm and axilla and improves the life quality of the patients after operations.