Breast Cancer Modified Radical Surgery Study Of Subcutaneous Effusion And Upper Extremity Edema

Objective:Surgery is one of the most important way to comprehensive treatment of breast cancer. Surgery can achieve the goal of local treatment, but also have some bad consequences for patients. Surgery can cause a variety of postoperative complications, such as subcutaneous effusion and upper limb lymphedema, in addition, as the surgery itself is a kind of patients with traumatic stress lowers the body's immune system, which will affect the development of the malignant tumor. The purpose of this study lies in the modified radical surgery of breast cancer risk factors, this study was to evaluate subcutaneous effusion of subcutaneous effusion occurred after further analysis and the correlation of the upper extremity lymphedema, and discusses in implementation of the new operation method (lats suture) to prevent the occurrence of postoperative patients with subcutaneous effusion and decrease of the relationship. Methods:The first part:the choice between January 2012 and December 2012 breast cancer patients undergoing surgery in our hospital during the period of a total of 508 cases were retrospectively analyzed. Statistics of 10 factors may be associated with patients of postoperative subcutaneous effusion:such as age, BMI (body mass index), tumor size, clinical stage, axillary scope, cleaning degree of axillary lymph node number, radiotherapy, chemotherapy and endocrine treatment, postoperative healing complications (including delayed union, infection, effusion, etc.). With the result of the obtained data were analyzed, and the SPSS19.0 analysis software to logistic regression method for processing. Continuity to the second part:choose breast cancer modified radical surgery cases,151 cases were analyzed retrospectively, divided into A, B two groups:the group A for the latissimus dorsi front suture group new surgical group (69 cases) and group B for daily operation group daily group (62 cases). This research adopts the latissimus dorsi front suture fixation in chest wall, as a new technology group of patients, daily operation methods for regular patients. Between A and B two groups the incidence of subcutaneous effusion and continuous drainage through comparison between the number of days and. The first part method and statistical method is the same. The third part:the continuous track to breast cancer modified radical surgery cases,504 cases were retrospectively analyzed. Collect the patient's general clinical data, clinical treatment and postoperative subcutaneous effusion and analyses the effect of upper limb lymphedema. Including subcutaneous effusion due to multiple factors affect the upper extremity lymphedema. The first part method and statistical method is the same. Results:The first part:from the clinical treatment to discharge track record, completed a total of 132 cases with subcutaneous effusion incidence was 18.9%, through the single factor analysis found that age, BMI, blood pressure, diabetes, patients with intraoperative inspection 3 days before the number of lymphatic, postoperative drainage fluid and TTV10 value associated with the occurrence of subcutaneous effusion (P< 0.05); Multiple factors analysis the patient age, BMI, detection of lymph node number and TTV10 are independent risk factors for the development of subcutaneous effusion. The second part:A, B two groups of patients in age size, with internal basic diseases, chemotherapy drugs, check out the number of lymph nodes, tumor diameter size had no significant difference in such aspects. Group A persistent, long drainage (TTV10) compared with group B decreased significantly (22.5% VS 37.8%, P= 0.029), also significantly reduce the incidence of subcutaneous effusion (16.8% VS 30.5%, P= 0.035). The third part:from the clinical treatment to discharge track after finishing, upper extremity edema, a total of 186 patients, the incidence was 23.7%, incidence of postoperative patients with upper limb edema fluid group is significantly higher than without effusion group (50% VS 34%, P< 0.002). In addition, patients with postoperative overweight obesity incidence of upper limb edema was also significantly increased (P< 0.05), such as age, with other internal basic diseases, neoadjuvant chemotherapy, check out the number of lymph nodes and postoperative conveyance in upper extremity edema in patients with no significant correlation. Conclusion:Patient age, BMI (body mass index), to detect the lymph node number and TTV15, long duration of drainage and postoperative risk factors for subcutaneous effusion; Can effectively reduce postoperative subcutaneous effusion and shorten drainage time is in the art of the latissimus dorsi frontal suture; And cause the upper extremity lymphedema patients postoperative subcutaneous effusion, subcutaneous effusion in patients with increased risk of upper extremity edema.