Sawai K, Nakajima H, Mizuta N, Sakaguchi K, Hachimine T
Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-Agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto 602-8566, Japan.
Gan To Kagaku Ryoho. 2001 Aug;28(8):1063-70.
Breast conservation surgery has become a standard operation as a minimally invasive surgery for breast cancer in Japan. Now sentinel lymph node biopsy (SLNB), day surgery, and endoscopy assisted surgery are being introduced as more minimally invasive surgeries for breast cancer. When blue dye and/or isotope are injected into the peri-tumoral breast gland, the sentinel lymph nodes (SLN) can be detected easily, and node negative patients can be selected with certainty. When no metastasis is found in SLN by frozen section, T1N0 breast cancer patients can be treated without lymph node dissection. Using this technique, day surgery for patients who have clinically node-negative small breast cancer (less than 1.5 cm in diameter) is performed under local anesthesia. We have developed an endoscopy assisted conservation surgery for breast cancer. Using endoscopy, partial or total glandectomy with radical axillary lymph node dissection is performed via a 5 cm skin incision on the middle axillary line. When the amount of glandectomy is over one third, we perform immediate reconstruction using the latissimus dorsi. These minimally invasive surgeries for breast cancer will result in a better quality of life for breast cancer patients.
在日本,保乳手术已成为乳腺癌微创手术的标准术式。如今,前哨淋巴结活检(SLNB)、日间手术及内镜辅助手术作为更微创的乳腺癌手术方式正在被引入。当将蓝色染料和/或同位素注入肿瘤周围的乳腺腺体时,前哨淋巴结(SLN)能够轻易被检测到,从而可以确定地筛选出淋巴结阴性患者。当通过冰冻切片在前哨淋巴结中未发现转移时,T1N0期乳腺癌患者可免于淋巴结清扫。利用该技术,对临床淋巴结阴性的小乳腺癌(直径小于1.5厘米)患者在局部麻醉下进行日间手术。我们已经研发出一种用于乳腺癌的内镜辅助保乳手术。通过在内侧腋中线做一个5厘米的皮肤切口,利用内镜进行部分或全腺体切除并同时行根治性腋窝淋巴结清扫。当腺体切除量超过三分之一时,我们使用背阔肌进行即刻重建。这些乳腺癌微创手术将为乳腺癌患者带来更高的生活质量。