原文
手術(shù)主要步驟及處理
患者取仰臥位，患肢外展，常規(guī)碘伏消毒術(shù)野兩遍，鋪無菌中單及有孔大單，全身麻醉滿意；取距腫瘤邊緣3cm處橫梭形切口，分離皮瓣：上至鎖骨下緣，下至肋弓上緣，內(nèi)至胸骨柄，外至背闊肌外緣，分離皮瓣較薄；切除全乳，保留胸大小肌，大拉鉤提起胸大肌，完整切除胸大小肌間脂肪組織，保留胸前神經(jīng)及血管，未見腫大淋巴結(jié)；銳性解切腋靜脈周圍淋巴結(jié)及脂肪組織至腋 尖，未見腫大淋巴結(jié)，保留胸背神經(jīng)、胸長神經(jīng)及肩部下脈管；細(xì)致止血，出血量少，于胸骨旁 及背闊肌前緣各置橡皮引流管一根，約15cm,接負(fù)壓吸引。嚴(yán)密縫合皮膚，皮膚張力小。加壓包扎傷口。術(shù)行順利，麻醉滿意，術(shù)后清點(diǎn)器械無誤，離體標(biāo)本送病理，患者安返病房。術(shù)后給予補(bǔ)液、免疫支持等治療。

譯文
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.