Professor Jiang Jun: endoscopic treatment of breast cancer -- from outside the box

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Lead: surgical treatment of breast cancer after a from "small" to "big", from "big" to "small" process. Now the concept of breast cancer sur


Lead: surgical treatment of breast cancer after a from "small" to "big", from "big" to "small" process. Now the concept of breast cancer surgery not only emphasizes the survival rate of patients, but also emphasizes the quality of life of patients. Perhaps this is the mirror surgery, breast conserving surgery is a background of the rapid development! We interviewed experts in domestic shuaixian carry out endoscopic surgery in breast cancer treatment, Professor Jiang Jun breast disease center of Southwest Hospital of Third Military Medical University.

Ding Xiangyuan: Hello, Professor Jiang, listen to the endoscopic treatment on breast cancer you are interested in the report. Excuse me, what do you think of the mirror when the technology is applied to breast cancer surgery go?

Jiang Jun: Professor of surgery in the treatment of breast cancer after a from "small" to "big", from "big" to "small" process, surgical treatment of breast cancer is now not only emphasizes the survival rate of the patients, also stressed that the quality of life of patients. Breast conserving surgery, sentinel lymph node biopsy is the best proof. So minimally invasive in a sense is the development trend of breast cancer surgery.

Southwest Hospital as a comprehensive hospital in the minimally invasive treatment of gastrointestinal and hepatobiliary surgery for the better, it can be said that we have a good foundation to carry out minimally invasive, so we want to be able to laparoscopic surgery applied to breast surgery?

First of all we think is to do with endoscopic axillary lymph node dissection. In mid 90s, we have done the research, will be for breast cancer patients before and after blood routine surgery were compared, found postoperative blood in exfoliated tumor cells increased compared to those before the operation, we analyze the reasons that should be caused by mechanical pressing of breast surgery. If you want to solve this problem there are 2 ways to go: the first is the "not touch", but in the conventional breast cancer surgery does not touch, do not pull the breast is very difficult to do. So we think of another way to block the metastasis of cancer cells. We know that the vast majority of the blood and lymph nodes of the breast are directed to the axilla, so if we first deal with the axilla, and then remove the tumor, then it is possible to block the vast majority of cancer cells into the bloodstream. But there is a problem with this, is the first axillary dissection, surgical exposure is not good. So, we thought of using mirrors to clean. This is one of our original intention.

Another idea is that some patients with benign lesions, such as breast benign tumors, precancerous lesions of patients with breast resection. If the conventional surgical approach, the incision is relatively large, the scar is relatively large. If used to do endoscopic incision to the small, but also more beautiful. Therefore, taking into account the breast lesions in patients with a better quality of life is one of our original intention. There is a male breast development, we will try to do with mirror.

So, generally speaking, we are always in the clinical encounter some difficult problem, then we can borrow the professional identification method to solve their own problems, the so-called "outside the box, so!

Ding Xiangyuan: is there any kind of minimally invasive surgery for breast cancer in foreign countries?

Professor Jiang: Yes

Ding Xiangyuan: so is the foreign counterparts earlier, or domestic earlier?

Professor Jiang Jun: it can not be said that domestic and foreign have created. Minimally invasive surgery for axillary lymph node dissection is done abroad, but they do not suggest that it may block the flow of blood from the shed. Radical resection of small incision on breast cancer, breast cancer, total laparoscopic operation is carried out before us.

Ding Xiangyuan: how about "breast disease endoscopic surgery operation guide 2008" is put forward in what kind of situation?

Professor Jiang: because the endoscopic treatment of breast disease is a kind of new technology, we compare the interest, but some doctors want to own breast groping to carry out, encounter a lot of problems. So the scientific branch of endocrine surgery group commissioned us to write about a laparoscopic treatment of breast disease in the technical guideline of Chinese Medical Association, such as how to correctly distinguish the endoscopic axillary vein problems during the operation of how to protect the domination of the pectoralis major muscle nerve. Since receiving this task, we have consulted a large number of domestic and foreign literature, and then integrated our experience from animal experiments to clinical practice to write this guidance document.

Ding Xiangyuan: how long does it take you to start working with a formal guide from the endocrine surgery unit?

Professor Jiang Jun: it took about 2 years! Accept the task from 2007 to the end of 2007, the Chinese Medical Association meeting group outside the science branch of endocrine surgery, we presented a technique outline, when many experts both in content and form have put forward many valuable opinions. Then in 2008, when we met in March submitted a draft, and then according to the views of everyone to modify. Finally, at the July 2008 meeting of the general assembly of the endocrine surgery experts voted in the Chinese Journal of surgery.

Ding Xiangyuan: Ding Xiangyuan website also has a lot of breast doctor, you can talk about to want to carry out this technology should pay attention to the place?

Professor Jiang: good. I want to have three aspects: ready first to have endoscopic surgery experience, if there is no contact with mirror, to do surgery, there is definitely a problem; then if a skilled surgeon on the breast, breast surgery often encounter problems to know; the third is to the breast and breast surrounding anatomical structures should be very familiar with, so as to make fewer mistakes. In addition, I would like to mention is that when a certain number of cases to verify their success or failure of the operation. For example, when you are breast tumor excision and axillary lymph node dissection by endoscopic, then finished, to the two incision open, to verify. If you do not have a clean cut, to seriously analyze the reasons, and constantly correct themselves, so as to gradually mature.

Ding Xiangyuan: Professor Jiang, thank you for your interview with Ding Xiangyuan.

Professor Jiang: good.

(source: Ding Xiangyuan)


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