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分析使用 SentiMag® 方法在乳腺癌患者中进行的 303 例前哨淋巴结识别手术后的并发症。

Analysis of Postoperative Complications After 303 Sentinel Lymph Node Identification Procedures Using the SentiMag® Method in Breast Cancer Patients.

机构信息

Department of Oncological Surgery, Prof. Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia in Katowice, Katowice, Poland.

Department VI of Trauma and Orthopaedics, District Hospital of Orthopedics and Trauma Surgery, Piekary Śląskie, Poland.

出版信息

Med Sci Monit. 2019 Apr 29;25:3154-3160. doi: 10.12659/MSM.912758.

Abstract

BACKGROUND The objective of this paper was to assess the complications following sentinel lymph node biopsy (SLNB) in breast cancer patients using the SentiMag® method. MATERIAL AND METHODS The study material consisted of 368 patients who had received the SLNB procedure in combination with wide local excision (WLE), simple mastectomy or who had an autonomous SLNB procedure in the period from January 2014 to September 2017. The final study group consisted of 303 patients who attended follow-up consultations. RESULTS Sensory disturbances in the arm occurred in 12 patients (9.9%), including 3 patients (1.5%) after WLE and 9 patients (8.4%) after simple mastectomy. Restricted mobility in the upper limb was experienced by 9 patients (7.1%), including 3 patients (1.5%) after WLE and 6 patients (5.6%) after simple mastectomy. Minimal-degree lymphedema developed in 9 patients (7.5%), including 2 patients (1%) after WLE and 7 patients (6.5%) after simple mastectomy. A significant correlation was demonstrated between the incidence of these complications and the number of lymph nodes dissected. A significantly higher incidence of paresthesia and lymphedema was revealed for simple mastectomy with SLNB when compared to WLE with SLNB. Discolorations upon tracer administration were observed in 47 patients (15.5%). CONCLUSIONS SentiMag® is a safe sentinel lymph node identification method used in breast cancer and has a low risk of complications. The rate of complications increases together with the number of dissected lymph nodes and the extent of the surgery. The possibility of temporary discolorations on the skin should be communicated to the patients explicitly prior to surgery.

摘要

背景

本研究旨在使用 SentiMag®方法评估乳腺癌患者前哨淋巴结活检 (SLNB) 后的并发症。

材料与方法

研究材料包括 2014 年 1 月至 2017 年 9 月期间接受 SLNB 联合广泛局部切除术 (WLE)、单纯乳房切除术或自主 SLNB 治疗的 368 例患者。最终研究组包括 303 例接受随访的患者。

结果

手臂感觉障碍 12 例(9.9%),其中 WLE 后 3 例(1.5%),单纯乳房切除术后 9 例(8.4%)。上肢活动受限 9 例(7.1%),WLE 后 3 例(1.5%),单纯乳房切除术后 6 例(5.6%)。轻度淋巴水肿 9 例(7.5%),WLE 后 2 例(1%),单纯乳房切除术后 7 例(6.5%)。这些并发症的发生率与切除的淋巴结数量之间存在显著相关性。与 SLNB 联合 WLE 相比,SLNB 联合单纯乳房切除术的感觉异常和淋巴水肿发生率明显更高。47 例患者(15.5%)在示踪剂给药后出现变色。

结论

SentiMag®是一种安全的乳腺癌前哨淋巴结识别方法,并发症风险低。并发症发生率随切除的淋巴结数量和手术范围的增加而增加。在手术前应明确告知患者皮肤暂时变色的可能性。

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