Li Shi-yong, Yu Bo, Liang Zhen-jia, Yuan Shu-jun
Department of General Surgery, Beijing Military Area General Hospital, Beijing 100700, China.
Zhonghua Wai Ke Za Zhi. 2004 Feb 7;42(3):155-7.
To study clinical effects of modified radical mastectomy with preservation of major and minor pectoral muscles.
A retrospective analysis was carried out in 214 cases of breast cancer patients (including stage I 66 cases, stage II 141 cases and stage III 7 cases). Modified radical mastectomy with preservation of major and minor pectoral muscles was performed on all the patients.
Out of 214 cases, 12 (5.6%) had subcutaneous fluid, 16 (7.4%) had skin flap margin necrosis. Upper limb lymphatic edema was found in 8 (3.7%) patients, and pectoral muscle contracture with dyspraxia of upper arm occurred in 11 (5.1%) cases. Three year survival rate was 82.3% and five year survival rate was 63.4%. For stage I patients, the five year survival rate attained to 79.6%, and stage II 56.3%.
Preservation of lateral branch of pectoral nerve can avoid complication of pectoral muscle contracture with dyspraxia of upper arm. Early chemotherapy of postoperation prevents breast cancer occurrence and metastasis. Comprehensive treat approaches for operative wound avert subcutaneous fluid, and complex therapy improves long-term effect of breast cancer patients.
研究保留胸大、小肌的改良根治性乳房切除术的临床效果。
对214例乳腺癌患者（其中Ⅰ期66例，Ⅱ期141例，Ⅲ期7例）进行回顾性分析。所有患者均行保留胸大、小肌的改良根治性乳房切除术。
214例患者中，12例（5.6%）出现皮下积液，16例（7.4%）出现皮瓣边缘坏死。8例（3.7%）患者出现上肢淋巴水肿，11例（5.1%）出现胸肌挛缩伴上臂活动障碍。三年生存率为82.3%，五年生存率为63.4%。Ⅰ期患者五年生存率达到79.6%，Ⅱ期为56.3%。
保留胸神经外侧支可避免胸肌挛缩伴上臂活动障碍的并发症。术后早期化疗可预防乳腺癌的发生和转移。手术切口的综合处理可避免皮下积液，综合治疗可提高乳腺癌患者的远期疗效。
