Clinical Application Of Lipolysis In Axillary Lymph Node Dissection For Breast Cancer

Breast cancer is the world’s largest cancer,a serious threat to women’s health and life.It is necessary to be familiar with the anatomical structure of axillary region in breast cancer patients undergoing endoscopic axillary lymph node dissection.The innovative expansion of lipolysis and liposuction provides operation space for minimally invasive surgery.In this paper,the clinical application of lipolysis technology in axillary lymph node dissection of breast cancer was studied,and axillary lymph node dissection time,blood loss,number of lymph node dissection,postoperative complications,quality of life score,quality of life and postoperative upper limb dysfunction,satisfaction with axillary appearance,axillary comfort were evaluated,Objective to provide a new basis for the application of lipolysis technique in axillary lymph node dissection of breast cancer.Methods: This study was divided into two groups:(1)the control group was not treated with lipolysis and liposuction.(2)The study group received endoscopic breast surgery.The dissection and dissection of axillary lymph nodes were performed by lipolysis and liposuction.Fat solution was prepared before operation;All the surgical procedures under endoscopy follow the spatial order of "from low to high",that is,from the bottom of the armpit(thoracodorsal nerve vessels,long thoracic nerve)to the middle of the armpit(lateral thoracic vessels,axillary veins,the second level lymph nodes of the posterior part of the pectoralis minor muscle),and then to the top of the armpit(Rotter lymph nodes and the third level lymph nodes of the pectoralis major and minor muscle space),In order to prevent the blood flow to the low position and interfere with the anatomical separation of the low position operation;In the lateral edge of pectoralis major muscle,we can touch the fat filled cavity space,namely axillary fat sac.In this area,the fat dissolving solution is evenly injected into the local bulge.After 10 to 15 minutes,insert a 20 ml syringe needle into the axillary fat sac for continuous liposuction.At the same time,suck out the dissolved liquid and the dissolved fat together,then wash with distilled water and suck out a small amount of insoluble tissue,which can be separated gently with thin scissors,so that the operation area can be clearly seen after the actual operation.At this time,the intercostobrachial nerve,the long thoracic nerve and the thoracodorsal nerve were completely preserved.At the same time,the axillary artery and vein branches and the surrounding lymphatic vessels were completely ligated.At this time,all axillary lymph nodes can be cleared with scissors,and the lymphatic vessels can be ligated directly;The dissected axillary lymphoid tissue specimens were soaked in the prepared fat solution for 15-20 minutes before dissection.The specimens were dissected by fixators.Axillary lymph node dissection time of two groups,blood loss,number of lymph node dissection,postoperative complications,quality of life score,quality of life and postoperative upper limb dysfunction,axillary shape satisfaction,axillary comfort were compared between the two groups.Results:(1)there was no significant difference in the amount of bleeding and lymph node clearance between the study group and the control group(P > 0.05).The time of axillary lymph node dissection in the study group was shorter than that in the control group,and the difference was statistically significant(P <0.05).(2)The postoperative complications of the two groups were analyzed: in the study group,there were 2 cases with upper limb numbness,2 cases with axillary pain and 1 case with thoracic muscle atrophy,and the complication rate was 6.25%.In the control group,there were 6 cases of numbness,4 cases of axillary pain and 4 cases of thoracic muscle atrophy.The incidence of complications was 17.50%.The incidence of complications in the study group was lower,the difference was statistically significant(P < 0.05).(3)The quality of life of the study group was better than that of the control group,and the difference between the basic score and the total score of the study group and the control group was statistically significant(P < 0.05).(4)There was no significant difference in ADL score between the two groups before operation(P > 0.05);ADL in the study group was significantly higher than that in the control group(P < 0.05).(5)The degree of upper limb dysfunction in the study group was light,the satisfaction score of axillary appearance and the comfort score of axillary were better than those in the control group,and the difference was statistically significant(P < 0.05).(6)Comparison of routine parameters in the process of axillary lymph node dissection between the two groups: there was no significant difference in lymph node pathology between the two groups(P > 0.05).The main parameters,such as drainage time and total drainage volume,were compared between the two groups,but there was no significant difference(P > 0.05).Conclusion: the combination of lipolysis and liposuction in axillary lymph node dissection of breast cancer can not only clean axillary lymph nodes,but also establish the operation space of laparoscopy,simplify the operation process,shorten the operation time,reduce the postoperative complications,and improve the quality of life of breast cancer patients.