Application of Ultracision Harmonic Scalpel and Skin Flap in Axillary Fossa External Fixation on Breast Cancer Operation . _CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TIAN Chao ,  LI Hui

Department of Breast Surgery, The Sichuan Province Tumor Hospital, Chengdu 610041, China;

Corresponding author：

LI Hui, Email: zlyy_lh@163.com

Keywords：

Breast cancer; Skin flap external fixation; Ultracision harmonic scalpel; Subcutaneous fluidity

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Objective To study the role of ultracision harmonic scalpel and skin flap in axillary fossa external fixation in operation of breast cancer. Methods One hundred and sixty-six patients with breast cancer were included in this study between May 2009 and November 2009. Combined group (n=51) applied ultracision harmonic scalpel combined with skin flap external fixation. External fixation group （n=52） used the skill of skin flap external fixation. Routine group included 63 patients. Operative time, accidental injury during operation， volume of bleed and drainage, time of drainage, detection amount of lymph node, and complications such like subcutaneous fluidity were observed and recorded. Results The operative time and detection amount of lymph node were not different among three groups （P gt;0.05）. The volume of bleed in combined group was less than that in other groups （P lt;0.05）. The volume of drainage and the time of drainage were decreased or shorten by turns from routine group, external fixation group to combined group （P lt;0.05）. The incidence rate of subcutaneous fluidity in combined group was lower than that in routine group （P lt;0.05）. Conclusions Using ultracision harmonic scalpel in operation of breast cancer can remarkably reduce the volume of bleed and drain postoperatively. Ultracision harmonic scalpel combined with skin flap external fixation is safety and can reduce the incidence rate of subcutaneous fluidity, thus can be applied widely in breast cancer operation.

Citation： TIAN Chao,LI Hui. Application of Ultracision Harmonic Scalpel and Skin Flap in Axillary Fossa External Fixation on Breast Cancer Operation . . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1245-1248. doi: Copy

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2.	Kashiwaba M, Inaba T, Takeda Y, et al. The ideal follow-up after breast cancer operation [J]. Gan To Kagaku Ryoho， 2009； 36(9): 1423-1427.
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5.	康华峰, 王西京, 刘小旭, 等. 皮瓣牵拉、固定预防乳腺癌手术后皮下积液和皮缘坏死 [J]. 陕西医学杂志, 2005； 34(12): 1493-1495， 1497.　.
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9.	李建军，李士秋，程勇，等. 皮瓣多点固定预防乳腺癌术后皮下积液的应用价值 [J]. 中国医药， 2007； 2(10): 624-626.
10.	Schinagl DA, van Tienhoven G. Breast cancer: disentangling the intricate Web [J]. J Clin Oncol， 2010； 28(17): e281.
11.	Elkhuizen PH, van Slooten HJ, Clahsen PC, et al. High Local recurrence risk after breast-conserving therapy in node-negative premenopausal breast cancer patients is greatly reduced by one course of perioperative chemotherapy: A European Organization for Research and Treatment of Cancer Breast Cancer Cooperative Group Study [J]. J Clin Oncol， 2000； 18(5): 1075-1083.
12.	Autier P, Héry C, Haukka J, et al. Advanced breast cancer and breast cancer mortality in randomized controlled trials on mammography screening [J]. J Clin Oncol, 2009； 27(35): 5919-5923.
13.	Anderson SJ, Wapnir I, Dignam JJ, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer [J]. J Clin Oncol, 2009； 27(15): 2466-2473.
14.	Chlebowski RT, Anderson G, Manson JE, et al. Estrogen alone in postmenopausal women and breast cancer detection by means of mammography and breast biopsy [J]. J Clin Oncol, 2010； 28(16): 2690-2697.
15.	Gilligan MA, Neuner J, Zhang X, et al. Relationship between number of breast cancer operations performed and 5-year survival after treatment for early-stage breast cancer [J]. Am J Public Health, 2007； 97(3): 539-544.
16.	Niehoff P, Ballardini B, Polgár C, et al. Early European experience with the MammoSite radiation therapy system for partial breast brachytherapy following breast conservation operation in low-risk breast cancer [J]. Breast, 2006； 15(3): 319-325.
17.	胡建昆, 张波, 陈心足, 等. 新型超声刀在胃癌根治术中的应用及技巧 [J]. 中国普外基础与临床杂志， 2008； 15（10）: 718-721.
18.	周洪伟，曾晓华，余永康，等. 超声刀在乳腺癌根治术中的临床应用研究 [J]. 临床超声医学杂志， 2004； 6(4): 213-215.
19.	刘春萍, 石岚, 程波, 等. 超声刀与电刀在乳腺癌手术治疗中应用效果比较 [J]. 华中医学杂志， 2005； 29（6）： 455-456.
20.	Husen M, Paaschburg B, Flyger HL. Two-step axillary operation increases risk of arm morbidity in breast cancer patients [J]. Breast, 2006； 15(5): 620-628.
21.	韦尉东，王欣，戎铁华，等. 乳腺癌手术保留肋间臂神经的方法及临床意义 [J]. 中华外科杂志， 2005； 43（17）： 1136-1138.
22.	Hongying WU, Shan ZC, Thakuri B. Origin and countermeasure for common skin flap complications after radical operation for breast cancer [J]. Kathmandu Univ Med J (KUMJ)， 2006； 4(1): 14-17.
23.	Krki A, Simonen R, Mlki E, et al. Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation [J]. J Rehabil Med, 2005； 37(3): 180-188.

1. Han J, Grothuesmann D, Neises M, et al. Quality of life and satisfaction after breast cancer operation [J]. Arch Gynecol Obstet, 2010； 282(1): 75-82.
2. Kashiwaba M, Inaba T, Takeda Y, et al. The ideal follow-up after breast cancer operation [J]. Gan To Kagaku Ryoho， 2009； 36(9): 1423-1427.
3. 许晓松, 姜军, 吴超，等. 多点固定缝合皮瓣与胸壁控制乳腺癌术后皮下积液 [J]. 中国厂矿医学， 2008； 21(1): 3.
4. 任兆增, 王寿强, 刘进健，等. 皮瓣固定在乳腺癌根治术中的应用 [J]. 中国现代普通外科进展， 2003； 4(1): 54.
5. 康华峰, 王西京, 刘小旭, 等. 皮瓣牵拉、固定预防乳腺癌手术后皮下积液和皮缘坏死 [J]. 陕西医学杂志, 2005； 34(12): 1493-1495， 1497.　.
6. Koyama H. Operation for breast cancers [J]. Nippon Rinsho, 2000； 58 Suppl: 168-172.
7. 左文述. 现代乳腺肿瘤病学 [M]. 第2版. 山东：山东科学技术出版社， 2006: 735-749.
8. 周兰兰. 锁骨固定带在乳腺癌根治术后防治腋窝皮下积液中的应用 [J]. 中国全科医学， 2009； 12(3B): 499-500.
9. 李建军，李士秋，程勇，等. 皮瓣多点固定预防乳腺癌术后皮下积液的应用价值 [J]. 中国医药， 2007； 2(10): 624-626.
10. Schinagl DA, van Tienhoven G. Breast cancer: disentangling the intricate Web [J]. J Clin Oncol， 2010； 28(17): e281.
11. Elkhuizen PH, van Slooten HJ, Clahsen PC, et al. High Local recurrence risk after breast-conserving therapy in node-negative premenopausal breast cancer patients is greatly reduced by one course of perioperative chemotherapy: A European Organization for Research and Treatment of Cancer Breast Cancer Cooperative Group Study [J]. J Clin Oncol， 2000； 18(5): 1075-1083.
12. Autier P, Héry C, Haukka J, et al. Advanced breast cancer and breast cancer mortality in randomized controlled trials on mammography screening [J]. J Clin Oncol, 2009； 27(35): 5919-5923.
13. Anderson SJ, Wapnir I, Dignam JJ, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer [J]. J Clin Oncol, 2009； 27(15): 2466-2473.
14. Chlebowski RT, Anderson G, Manson JE, et al. Estrogen alone in postmenopausal women and breast cancer detection by means of mammography and breast biopsy [J]. J Clin Oncol, 2010； 28(16): 2690-2697.
15. Gilligan MA, Neuner J, Zhang X, et al. Relationship between number of breast cancer operations performed and 5-year survival after treatment for early-stage breast cancer [J]. Am J Public Health, 2007； 97(3): 539-544.
16. Niehoff P, Ballardini B, Polgár C, et al. Early European experience with the MammoSite radiation therapy system for partial breast brachytherapy following breast conservation operation in low-risk breast cancer [J]. Breast, 2006； 15(3): 319-325.
17. 胡建昆, 张波, 陈心足, 等. 新型超声刀在胃癌根治术中的应用及技巧 [J]. 中国普外基础与临床杂志， 2008； 15（10）: 718-721.
18. 周洪伟，曾晓华，余永康，等. 超声刀在乳腺癌根治术中的临床应用研究 [J]. 临床超声医学杂志， 2004； 6(4): 213-215.
19. 刘春萍, 石岚, 程波, 等. 超声刀与电刀在乳腺癌手术治疗中应用效果比较 [J]. 华中医学杂志， 2005； 29（6）： 455-456.
20. Husen M, Paaschburg B, Flyger HL. Two-step axillary operation increases risk of arm morbidity in breast cancer patients [J]. Breast, 2006； 15(5): 620-628.
21. 韦尉东，王欣，戎铁华，等. 乳腺癌手术保留肋间臂神经的方法及临床意义 [J]. 中华外科杂志， 2005； 43（17）： 1136-1138.
22. Hongying WU, Shan ZC, Thakuri B. Origin and countermeasure for common skin flap complications after radical operation for breast cancer [J]. Kathmandu Univ Med J (KUMJ)， 2006； 4(1): 14-17.
23. Krki A, Simonen R, Mlki E, et al. Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation [J]. J Rehabil Med, 2005； 37(3): 180-188.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Ultracision Harmonic Scalpel and Skin Flap in Axillary Fossa External Fixation on Breast Cancer Operation . 

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