胸腔镜内乳前哨淋巴结活检和内乳淋巴链切除的实验研究

目的探讨胸腔镜下内乳前哨淋巴结活检和内乳淋巴链切除的可行性。方法实验用小型母猪6头，双腔管气管插管全身麻醉。胸前第1对乳房皮下注射亚甲蓝4ml，经胸腔镜观察内乳前哨淋巴结蓝染时问，超声刀切除内乳前哨淋巴结和内乳淋巴链，记录手术时间。结果6头小型母猪共12侧内乳前哨淋巴结和内乳淋巴链，采用胸腔镜联合淋巴结蓝染定位法成功切除，内乳前哨淋巴结蓝染时间5～15min，平均8．9min；活检时间15—50min，平均30．4min；内乳淋巴链切除时间分别为左侧30—56min，右侧22～48min，平均38．2min。无出血、肺损伤等手术并发症发生。结论胸腔镜内乳前哨淋巴结活检和内乳淋巴链切除是可行的，手术操作简便、创伤较小。

Thoracoscopic internal mammary sentinel node biopsy and internal mammary lymph chain excision: An experimental study

Objective To investigate the feasibility of internal mammary sentinel node(SN) biopsy and internal mammary lymph chain excision under thoracoscope. Methods Six small pigs were used for the experiment.The small pigs were intubated using a double lumen endotracheal tube and kept anesthetized with ketamine.Methylene blue(4 ml) was injected subdermally into both of the first pair of breast.The sentinel node biopsy and internal mammary lymph chain dissection was performed thoracoscopically using a harmonic scalpel.Time of the appearance of the first blue-stained node and the dissection procedure were recorded respectively.Results Thoracoscopic internal mammary sentinel node dissection and internal mammary lymph chain excision was performed successfully in all the 6 pigs(12 sides).The time of the appearance of the first blue-stained sentinel node was 5~15 min(mean,8.9 min),the time of thoracoscopic biopsy was 15~50 min(mean,30.4 min),and the time of internal mammary lymph chain excision was 30~56 min on the left side and 22~48 min on the right side(mean,38.2 min),respectively.No bleeding,lung injuries,and other surgical complications occurred. Conclusions Thoracoscopic internal mammary sentinel node dissection and internal mammary lymph chain excision is feasible,easy to perform,and minimally invasive.