CAJ | 학술논문

目的：探讨保留肋间臂神经和胸前神经在乳腺癌改良根治腋窝淋巴结清扫术中的应用。方法回顾性分析84例乳腺癌改良根治术患者的临床资料，其中腋窝淋巴结清扫时保留肋间臂神经和胸前神经的41例，另切除该组神经的43例；比较两组的手术时间、术中出血量、腋窝淋巴结清扫数目、上臂内侧、腋部及胸壁皮肤感觉异常及胸大肌萎缩情况。结果两组手术时间、术中出血量及清扫腋窝淋巴结数目分别为[（104．7±10．3）min vs （97．0±7．2）min]、[（100．8±15．2）ml vs （97．1±9．3）ml]、[（18．6±2．6）枚 vs （19．3±2．3）枚]，组间差异均无统计学意义（P＞0．05）；随访6个月感觉异常及胸大肌萎缩的发生率分别为14．6％ vs 62．8％、17．1％ vs 74．4％，两组相比保留神经组的发生率均显著低于未保留神经组（P＜0．01）。结论在乳腺癌改良根治腋窝淋巴结清扫术中保留肋间臂神经和胸前神经是安全可行的，可有效防止皮肤感觉障碍及胸大肌萎缩。
목적：탐토보류륵간비신경화흉전신경재유선암개량근치액와림파결청소술중적응용。방법회고성분석84례유선암개량근치술환자적림상자료，기중액와림파결청소시보류륵간비신경화흉전신경적41례，령절제해조신경적43례；비교량조적수술시간、술중출혈량、액와림파결청소수목、상비내측、액부급흉벽피부감각이상급흉대기위축정황。결과량조수술시간、술중출혈량급청소액와림파결수목분별위[（104．7±10．3）min vs （97．0±7．2）min]、[（100．8±15．2）ml vs （97．1±9．3）ml]、[（18．6±2．6）매 vs （19．3±2．3）매]，조간차이균무통계학의의（P＞0．05）；수방6개월감각이상급흉대기위축적발생솔분별위14．6％ vs 62．8％、17．1％ vs 74．4％，량조상비보류신경조적발생솔균현저저우미보류신경조（P＜0．01）。결론재유선암개량근치액와림파결청소술중보류륵간비신경화흉전신경시안전가행적，가유효방지피부감각장애급흉대기위축。
Objective To investigate the application of preserving the intercostobrachial nerve (ICBN)and anterior thoracic nerve(ATN)during axillary lymph node dissection in modified radical mas-tectomy for breast cancer.Methods The clinical data of 84 patients who underwent modified radical mas-tectomy for breast cancer were reviewed retrospectively.During the axillary lymph node dissection,ICBN and ATN were preserved in 41 cases and resected in the other 43 cases.The operative time,operation hem-orrhage,number of dissected lymph nodes,incidence rate of abnormal sensory function and atrophy of the major pectoral muscle were analyzed in all the patients.Results There were no significant differences in operative time [(104.7 ±10.3)min vs(97.0 ±7.2)min],hemorrhage [(100.8 ±15.2)ml vs(97.1 ± 9.3)ml]and lymph node number [(18.6 ±2.6)vs(19.3 ±2.3)]between the two groups(P>0.05). There were significant differences in the incidence rate of abnormal sensory function(14.6% vs 62.8%) and atrophy of the major pectoral muscle(17.1%vs 74.4%)between the preservation group and resection group(P<0.01).Conclusion Preservation of ICBN and ATN is a feasible and safe technique during ax-illary lymph node dissection in modified radical mastectomy for breast cancer.It could decrease the inci-dence of abnormal sensory function and atrophy of the major pectoral muscle.