Clinical Study Of The Effect Of Preserving ICBN On Postoperative Pain Syndrome In Modified Radical Mastectomy Of Breast Cancer

Objective To investigate the effect of preserving intercostobrachial nerve in radical mastectomy on postoperative pain syndromeMaterials and Methods116 cases of breast cancer patients who saw doctors in either the General Surgery Department II of Minda Hospital of Hubei Minzu University or the Breast Surgery Department of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from December 1^st,2017 to November 31^st,2018are selected in this study.Those patients are then randomly divided into the group of patients?55 cases?whose intercostobrachial nerves are preserved and group of patients whose intercostobrachial nerves?61 cases?are not preserved.The differences in terms of age,time of operation,intraoperative blood loss,lymphadenectomy,clinical stages,pathological types,expression of hormone types and metastasis and recurrence rates between the two groups of patients are compared.The positions on the two groups of patients where their postoperative pains take place are analyzed,including the changes of different types of pains within one week,one month,three months and six months after the operation so as to analyze the difference between the two groups in terms of the occurrence rate of PMPS.Result The result of the comparison between the two groups in terms of time of operation,intraoperative blood loss and lymphadenectomy shows that the differences have no statistical significance?t=0.171,P=0.286.t=0.41,P=0.162.t=-1.503,P=0.136?.There is no statistical significance as for the differences between the two groups in terms of clinical stages,pathological types and the expressions of ER,PR and Her-2??²=3.516,P=0.319.?²=0.959,P=0.619.?²=0.288,P=0.591.?²=0.556,P=0.456.?²=1.217,P=0.270?.There is statistical significance as for the differences between the two groups in terms of position of pain,surgical area,armpit of the affected side,medial,back or front side of upper arm??²=4.146,P=0.042.?²=4.592,P=0.032.?²=4.408,P=0.028.?²=5.643,P=0.018.?²=4.333,P=0.037?However,the difference in terms of pain on the lateral side of the upper arm has no statistical significance??²=2.202,P=0.138?.The difference between the hypoesthesia,dysesthesia,hyperesthesia,numb and ant-crawling sensation that the two groups of patients have within 1 week after the operation bears statistical significance??²=5.047,P=0.025.?²=4.376,P=0.036.?²=10.428,P=0.001.?²=9.375,P=0.002.?²=5.416,P=0.020?,sodoesthatfor1month??²=5.047,P=0.025.?²=4.376,P=0.036.?²=10.428,P=0.001.?²=9.375,P=0.002.?²=5.416,P=0.020?and3months??²=4.891,P=0.027.?²=4.161,P=0.041.?²=6.252,P=0.012.?²=5.416,P=0.020.?²=5.256,P=0.022?.The difference between the hypoesthesia,hyperesthesia and numb that the two groups of patients have within 6 months after the operation bears statistical significance??²=7.007,P=0.008.?²=7.284,P=0.007.?²=5.733,P=0.017?,while the difference between dysesthesia and ant-crawling sensation bears no statistical significance??²=1.500,P=0.221.?²=3.295,P=0.069?.The difference between the two groups for the occurrence of PMPS bears statistical significance??²=10.286,P=0.001?.The number of patients who are having light pain,uncomfortable pain,embarrassing pain and unbearable pain after the operation are 7?12.7%?,5?9.1%?,3?5.5%?,2?3.6%?,24?39.3%?,16?26.2?11?18.0%?,7?11.5%?and 3?4.9%?respectively among the two groups.The difference between the two groups in terms of the feel of the existing pains bears statistical significance??²=10.451,P=0.033?.However,no significant difference can be found if SF-MPQP is applied in evaluating the nature of the pains being suffered by PMPS patients.There is no statistical significance in terms of the difference between the reoccurrence and metastasis rates between the two groups for a half year after the operation??²=0.084,P=0.772.?²=0.163,P=0.686?.Conclusion 1.The preservation of intercostobrachial nerve in a modified radical mastectomy does not prolong the time of operation,nor does it increase the intraoperative blood loss,affect the intraoperative lymphadenectomy and increase the reoccurrence and metastasis rates over a short period of time.2.The preservation of intercostobrachial nerve in a modified radical mastectomy can reduce the sensory disturbance that appears at the early postoperative period.3.The preservation of intercostobrachial nerve in a modified radical mastectomy can lower down the occurrence rate of PMPS.