Abstract
Objective To systematic review the efficacies of endoscopic - assisted axillary lymph node dissection and conventional open axillary lymph node dissection in patients with breast cancer in order to provide evidence for doctors and patients in selecting operation methods. Methods Randomized controlled trials ( RCTs ) on endoscopic - assisted axillary lymph node dissection and conventional open axillary lymph node dissection in the treatment of breast cancer were searched from PubMed, EMBase, Chinese biomedical literature database ( CBM ) and China Journal Full - text Database ( CNKI ), and the relevant published data, conference papers and their references either in English or Chinese were also searched manually. The Chinese searching words were breast tumor, breast cancer, laparoscope, axillary lymph node dissection, randomized and controlled. The English searching words were breast cancer, breast tumor, randomized controlled trial, axillary lymph node dissection, axillary dissection, endoscope and cavity mirrors. The data were extracted and the methodological quality of the involved researches was e-valuated by two reviewers independently, and RevMan 5. 1 software was used for Meta - analysis. Results A total of 7 RCTs were involved, including 428 patients. Meta analysis showed that compared with conventional open axillary lymph node dissection, endoscopic - assisted axillary lymph node dissection operation could reduce the armpit lymph drainage volume [ WMD = -139. 02, 95% CI ( - 160. 99, - 117. 05 ) ], and prolong the operation time [ WMD =42. 98, 95% CI ( 21. 34, 64. 61 ) ], but showed no statistically significant differences in the amount of intra - operative bleeding [ WMD = - 21. 29, 95% CI ( -43. 34, - 0. 75 ) ], intra - operative cleaned lymph node number [ WMD = - 1. 48 , 95% CI ( - 3. 49, 0. 52 ) ], axillary drainage time [ WMD =-1.58, 95% CI ( - 10. 54, 7. 39 ) ], post - operative complications [ OR = 0. 68 , 95% CI ( 0. 31,1. 46 ) ], post - operative hospitalization time [ WMD = - 0. 23, 95% CI ( - 0. 79, 0. 33 ) ] and post - operative recurrence [ OR = 2. 39, 95% CI ( 0. 58, 9. 84 ) ] . Conclusion Endoscopic - assisted axillary lymph node dissection should be promoted owing to its advantages of minimal invasion, low complication rate, rapid recovery and invisible scar. However, the surgical technique remains to be further improved to reduce the prolonged operating time. Because of the low quality of the involved researches , the above conclusion still need to be validated by carrying out more randomized controlled trials with multiple centers and bigger sample and enough follow - up time.
关键词
乳腺肿瘤/内窥镜/腋窝淋巴结清扫术/Meta分析Key words
Breast neoplasms/ Endoscopes/ Axillary lymph node dissection/ Meta - analysis分类
医药卫生
