Tatsuta M, Hashimoto K, Masutani S, Morimoto O, Tsuji Y, Baba M, Miya A, Ishida H, Kawasaki T, Satomi T, Hoshida Y, Yoshioka H, Yoshimura H
Dept. of Surgery, Sakai Municipal Hospital.
Gan To Kagaku Ryoho. 1998 Jul;25(9):1336-40.
The conventional methods (CM) of intraarterial (IA) chemotherapy for inflammatory breast cancer were catheterizations from superior epigastric and brachial artery under general anesthesia. Since 1997, we selected the Seldinger's methods (SM) for ten cases of the disease to control local effects and simplify the technique. Complications of the SM were slight, and side effects were equal to those with CM. The postoperative pathological findings of the SM showed the direct effects of chemotherapy to tumor cells (degenerative and necrotic changes) as compared with the embolism-like effects of CM. But the overall histological effects of chemotherapy by SM were almost equal to those for CM. The strong points of the SM were as follows: 1) More selective IA chemotherapy is available, 2) one can find the passage of the aim vessels and no trouble related to catheter, 3) general anesthesia is not necessary, and the techniques are simple, 4) the wounds are not remarkable. The disadvantages are as follows: 1) Patients must rest the day of IA chemotherapy, 2) in 20% of the procedures, one can not search the vessels, and 3) in 4 cases complications of stiffness of Mj or Mn pectral muscles were found. In future, we expect more effective results by dose escalation or combination chemotherapy.
炎性乳腺癌动脉内化疗的传统方法（CM）是在全身麻醉下经上腹壁动脉和肱动脉进行插管。自1997年以来，我们对10例该疾病患者采用了Seldinger法（SM）来控制局部效果并简化操作技术。SM的并发症轻微，副作用与CM相当。与CM的类似栓塞效果相比，SM的术后病理结果显示化疗对肿瘤细胞有直接作用（退行性和坏死性改变）。但SM化疗的总体组织学效果与CM几乎相同。SM的优点如下：1）可进行更具选择性的动脉内化疗；2）能找到目标血管的通路且无导管相关问题；3）无需全身麻醉，技术简单；4）伤口不明显。缺点如下：1）患者在动脉内化疗当天必须休息；2）在20%的操作中无法找到血管；3）有4例出现胸大肌或胸小肌僵硬并发症。未来，我们期望通过增加剂量或联合化疗获得更有效的结果。
