Serra G E, Maccarone G B, Ibarra P E, de la Fuente R
J Surg Oncol. 1984 Aug;26(4):278-81. doi: 10.1002/jso.2930260415.
The preservation of the medial pectoralis nerve is classical and compulsory in the Patey Modified Radical Mastectomy, which innervates the clavicular and sternal insertions of the pectoralis major muscle. The lateral pectoralis nerve innervates the lower third, and the costo-abdominal insertions of the pectoralis major muscle. The tight relationship of this nerve with the pectoralis minor muscle makes it impossible to resect the muscle without damaging the nerve. The lesion of this nerve causes fibrosis, atrophy and shortening of the pectoralis major muscle, limitations of the shoulder movements, and a certain degree of skeletonization of the chest wall. Routine removal of the pectoralis minor muscle, as seen in Patey's type operation, with sectioning of the lateral pectoralis nerve, and the above mentioned sequela, is not recommended since it destroys the cosmetic result which is the main objective of the surgery. In naming these structures we prefer Moosman's proposal, because it is easier to remember, it adapts better to our surgical training, and it denotes course location and distribution. We encourage the preservation of the pectoralis minor muscle, and the lateral pectoralis nerve in the modified radical mastectomy, following the Scanlon's proposal in the hope of maintaining a cosmetic aspect and an appropriate base for the reconstructive surgery.
在帕蒂改良根治性乳房切除术中，保留胸内侧神经是经典且必须的，该神经支配胸大肌的锁骨部和胸骨部附着点。胸外侧神经支配胸大肌的下三分之一以及肋腹部附着点。该神经与胸小肌关系紧密，使得在不损伤神经的情况下切除胸小肌成为不可能。该神经损伤会导致胸大肌纤维化、萎缩和缩短，限制肩部活动，并造成一定程度的胸壁骨骼化。不建议像帕蒂术式那样常规切除胸小肌并切断胸外侧神经，因为上述后遗症会破坏手术的主要目标——美观效果。在命名这些结构时，我们更倾向于莫斯曼的提议，因为它更容易记忆，更符合我们的手术训练，且能表明走行位置和分布。我们鼓励在改良根治性乳房切除术中按照斯坎伦的提议保留胸小肌和胸外侧神经，以期保持美观外观并为重建手术提供合适基础。
