Sentinel lymph node biopsy performed under local anesthesia is feasible
Sentinel lymph node biopsy performed under local anesthesia is feasible
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DOI：
10.1016/j.amjsurg.2003.09.009
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发表时间：
2004-06-01
影响因子：
3
通讯作者：
Strobbe, LJA
中科院分区：
文献类型：
--
作者：
Smidt, ML;Janssen, CMM;Strobbe, LJA
背景资料：在局部麻醉（LA）下进行的乳腺癌患者前哨淋巴结（SLN）活检可能具有更有效地利用手术室时间和病理学家时间等优点。它还提供了一个组织学诊断前进行明确的乳房手术。本研究的目的是通过比较在LA和全身麻醉（GA）下进行SLN手术的结果来评估可行性。方法：对50例门诊和167例住院的临床T1-2NO乳腺癌患者分别在LA和GA下进行SLN手术。比较两组的前哨淋巴结检出率，即映射和收获的前哨淋巴结的比较。还测量了在LA下进行的前哨淋巴结活检的持续时间。结果：两组中，每例患者平均收获2个前哨淋巴结。LA组的检出率为1.00，GA组为0.99。SLN程序下LA的学习曲线显示，连续几个月的持续时间减少（不显着）。结论：SLN活检可以安全和充分地进行与患者下LA。它允许早期诊断淋巴结状态，获得门诊的基础上，以最小的不适，病人。学习曲线表明，如果外科医生在SLN活检方面有经验，则可以快速掌握LA手术。(C)2004 Excerpta Medica，Inc. All rights reserved.
Background: A sentinel lymph node (SLN) biopsy in breast cancer patients, performed under local anesthesia (LA), could have advantages such as more efficient use of operating room time and pathologist time. It also provides a histologic diagnosis before definitive breast surgery is undertaken. The aim of this study was to assess feasibility by comparing the results of SLN procedures performed under LA versus general anesthesia (GA).Methods: The SLN procedure was performed in 50 consecutive outpatients and 167 inpatients with clinical T1-2NO breast cancer while they were under LA and GA, respectively. The SLN detection rate, a comparison of mapped and harvested SLNs, was compared for both groups. The duration of the SLN biopsies performed under LA was also measured.Results: For both groups a median of 2 SLNs/patient were harvested. The detection rate was 1.00 for the LA group and 0.99 for the GA group. The learning curve for SLN procedures under LA showed a decrease in duration for the consecutive months (not significant).Conclusions: SLN biopsy can be safely and adequately performed with the patient under LA. It allows early diagnosis of the lymph node status, acquired on an outpatient basis, with minimal discomfort to the patient. The learning curve demonstrated that the LA procedure can quickly be mastered if the surgeon is experienced in performing SLN biopsies. (C) 2004 Excerpta Medica, Inc. All rights reserved.