保留胸前神经和肋间臂神经的横切口乳腺癌改良根治术(附40例临床分析)

目的：探讨在乳腺癌改良根治术中采用横切口，并保留胸前神经和肋问臂神经，对术后皮瓣成活、胸大小肌功能、患侧上臂感觉功能的影响。方法：40例乳腺癌均采用横切口乳腺癌改良根治术，清扫时注意保留胸前神经及肋问臂神经。术后检查胸大小肌萎缩情况和患侧上臂内侧的感觉、运动功能变化。结果：术后发生切口皮瓣坏死3例，胸大小肌无明显萎缩，28例保留肋问臂神经患侧上臂内侧皮肤感觉良好，活动自如。结论：保留胸前神经，肋间臂神经的横切口乳腺癌改良根治术减少了术后并发症的发生率，改善了生存质量。

Clinical Analysis of Preserving the Anterior Thoracic Nerve and the Intercostobrachial Nerve by Transverse Incision in Modified Radical Mastectomy (40 Cases Report)

Objective To study the influence of the modified radical mastectomy with transverse incision to preserve the anterior thoracic nerve and the intercostobrachial nerve on postoperative survival rate of skin flap, the functions of the major and minor pectoral muscles and the sense function of the upper arm on the ill side. Methods All 40 cases of breast carcinoma were used the transverse incision in the modified radical mastectomy. The anterior thoracic nerves and the intercostobrachial nerves were saved in lymph node dissection. The atrophy condition of the major and minor pectoral muscles after operation, the sensation and motor function of ill side's upper arm were observed. Results Necrosis of skin flap after operation occurred in 3 cases, but no phanero atrophy of the major and minor pectoral muscles occurred after operation. Sense and motor function of ill side's upper arm were pretty well in 28 patients whose intercostobrachial nerve were preserved. Conclusions Using the transverse incision and preserving anterior thoracic nerve intercostobrachial nerve can reduce the incidence rate of complications after operation, promote the quality of life and relieve the psychic burden of patients.