原文
手术主要步骤及处理
患者取仰卧位，患肢外展，常规碘伏消毒术野两遍，铺无菌中单及有孔大单，全身麻醉满意；取距肿瘤边缘3cm处横梭形切口，分离皮瓣：上至锁骨下缘，下至肋弓上缘，内至胸骨柄，外至背阔肌外缘，分离皮瓣较薄；切除全乳，保留胸大小肌，大拉钩提起胸大肌，完整切除胸大小肌间脂肪组织，保留胸前神经及血管，未见肿大淋巴结；锐性解切腋静脉周围淋巴结及脂肪组织至腋 尖，未见肿大淋巴结，保留胸背神经、胸长神经及肩部下脉管；细致止血，出血量少，于胸骨旁 及背阔肌前缘各置橡皮引流管一根，约15cm,接负压吸引。严密缝合皮肤，皮肤张力小。加压包扎伤口。术行顺利，麻醉满意，术后清点器械无误，离体标本送病理，患者安返病房。术后给予补液、免疫支持等治疗。
译文
Surgical procedures and treatments:
The patient was in a supine position with the affected extremity spread. Then, routine disinfection was performed twice using iodophors. Sterile drapes and large drapes with holes were used and general anesthesia was satisfactory. A Fusiform incision was made at a position that is 3cm away from the margin of tumor, based on which the skin flap was separated from the inferior margin of clavicle to upper margin of costal arch, and from manubrium sterni to exterior margin of latissimus dorsi muscle. The separated skin flap was comparatively thin. The whole breast was excised, while pectoralis major/minor muscles were reserved. The pectoralis major muscle was raised by a large wire retractor and adipose tissues between pectoralis major muscle and pectoralis minor muscle were excised totally. Nervous pectoralis cranialis and blood vessels were reserved and no lymphadenectasis was seen. Peripheral lymph nodes of axillary vein were cut off using sharp incision, and adipose tissues were separated until reaching the apical axilla. No lymphadenectasis was observed. Thoracodorsal nerve, long thoracic nerve and vessels below the shoulder were reserved. Hemostasis was performed carefully and few hemorrhage volume was noticed. An elastic drainage tube (about 15cm) was inserted in the parasternal and anterior margin of latissimus dorsi muscle respectively, and vacuum aspiration was carried out. The skin was sutured and light tension was noted. On this basis, pressure dressing was conducted. The surgery was successful and general anesthesia was satisfactory. After the surgery, instruments were counted. The sample was submitted for pathological examination. The patient was transferred to the ward. Postoperative managements were performed such as fluid infusion and immune supporting therapy.
