乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的前瞻性随机对照试验。
Prospective randomized controlled trial of preservation of the intercostobrachial nerve during axillary node clearance for breast cancer.
作者信息
Abdullah T I, Iddon J, Barr L, Baildam A D, Bundred N J
机构信息
Academic Breast Unit, University Hospital of South Manchester, West Didsbury, UK.
出版信息
Br J Surg. 1998 Oct;85(10):1443-5. doi: 10.1046/j.1365-2168.1998.00843.x.
BACKGROUND
Complications of axillary surgery occur due to severance of the intercostobrachial nerve (ICBN). The feasibility and benefit of preserving the ICBN to prevent sensory loss was studied prospectively.
METHODS
Sensory symptoms and deficits were documented, and shoulder movement and arm circumference were measured at discharge and 3 months later in 120 patients randomized to either preservation or division of the ICBN.
RESULT
Preserving the ICBN was feasible in 39 (65 per cent) of the 60 patients randomized to the preservation group. Preserving the nerve prolonged the procedure by a median of 5 min. No difference in sensory symptoms between the groups was seen at 3 months. At 3 months 53 per cent of patients randomized to ICBN preservation had a sensory deficit compared with 84 per cent of those randomized to ICBN sacrifice (P < or = 0.05).
CONCLUSION
Preserving the ICBN reduces the incidence of sensory deficit (but not symptoms) in patients after axillary clearance.
背景
腋部手术的并发症是由于肋间臂神经（ICBN）离断所致。前瞻性地研究了保留ICBN以预防感觉丧失的可行性和益处。
方法
记录感觉症状和功能缺失情况，并在120例随机分为保留或离断ICBN的患者出院时及3个月后测量肩部活动度和上臂围。
结果
随机分入保留组的60例患者中，39例（65%）成功保留了ICBN。保留神经使手术时间平均延长5分钟。3个月时两组间感觉症状无差异。3个月时，随机分入ICBN保留组的患者中有53%存在感觉功能缺失，而随机分入ICBN离断组的患者中这一比例为84%（P≤0.05）。
结论
保留ICBN可降低腋窝清扫术后患者感觉功能缺失（而非症状）的发生率。
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