环乳晕微小切口腔镜辅助下乳腺区段切除手术的临床观察
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摘要
目的探讨环乳晕微小切口腔镜辅助下乳腺区段切除手术的临床疗效。方法乳腺良性疾病患者41例,根据手术方式不同,研究组为环乳晕微小切口腔镜辅助下乳腺区段切除术患者20例,对照组为传统乳腺区段切除术患者21例。比较两组手术时间、术中出血量、切口大小、切口与病变外侧缘的距离、术后并发症、术后住院时间及术后1个月患者疤痕长度和对美容效果的主观满意度情况。结果研究组在术中出血量、术后住院时间、术后并发症上与对照组比较,差异无统计学意义(P>0.05);而在手术时间、切口与病变外侧缘的距离、切口长度、术后1月的疤痕长度和患者主观满意度上比较,两组差异有统计学意义(P<0.05)。结论环乳晕腔镜辅助下乳腺区段切除术切口微小,术后疤痕小,美容效果优势明显,患者满意度较高,有很好的临床应用前景。
Objective To investigate the clinical effect of segmental mastectomy by endoscope-assist with the micro-incision beside the annular areola.Methods 41 patients with benign breast disease,according to different surgical methods,were divided into the study group and the control group.The study group was20 patients with breast segmentectomy under the help of ring-shaped areola microsurgery,and the control group was 21 patients with conventional breast segmentectomy. The operation time,intraoperative blood loss,incision size,distance between the incision and the lateral side of the lesion,postoperative complications,postoperative hospital stay,and the length of the scar and the subjective satisfaction of the cosmetic effect were compared between the two groups.Results The differences were no statistically significant between the study group and the control group in volume of intraoperative blood loss,time of postoperative hospital stay and postoperative complications( P>0.05).But the differences were statistically significant in operative time,incision size,distance between incision and the lateral margin of the lesion,postoperative scar length and subjective satisfaction with cosmetic effect of the patients in one month after surgery( P<0.05).Conclusion The incision of segmental mastectomy by endoscope-assist beside the annular areola is tiny,the postoperative scars are small,and it has obvious advantages in the cosmetic effect,and the satisfaction of patients is higher.It has a good clinical application.
Objective To investigate the clinical effect of segmental mastectomy by endoscope-assist with the micro-incision beside the annular areola.Methods 41 patients with benign breast disease,according to different surgical methods,were divided into the study group and the control group.The study group was20 patients with breast segmentectomy under the help of ring-shaped areola microsurgery,and the control group was 21 patients with conventional breast segmentectomy. The operation time,intraoperative blood loss,incision size,distance between the incision and the lateral side of the lesion,postoperative complications,postoperative hospital stay,and the length of the scar and the subjective satisfaction of the cosmetic effect were compared between the two groups.Results The differences were no statistically significant between the study group and the control group in volume of intraoperative blood loss,time of postoperative hospital stay and postoperative complications( P>0.05).But the differences were statistically significant in operative time,incision size,distance between incision and the lateral margin of the lesion,postoperative scar length and subjective satisfaction with cosmetic effect of the patients in one month after surgery( P<0.05).Conclusion The incision of segmental mastectomy by endoscope-assist beside the annular areola is tiny,the postoperative scars are small,and it has obvious advantages in the cosmetic effect,and the satisfaction of patients is higher.It has a good clinical application.
引文
[1]佘青,李怀有,程永刚,等.乳腔镜改进法在乳房良性疾病中的应用[J].临床医学研究与实践,2018,3(6):56-57.
[2]王品,吴剑,郭慧敏,等.经腋窝腔镜切除与传统乳晕切口手术治疗男性乳腺发育症的临床对照观察[J].中国美容整形外科杂志,2018,29(7):395-398.
[3] Ordaz DL,Thompson JK.Gynecomastia and psychological functioning:a review of the literature[J]. Body Image,2015,15:141-148.
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[5]刘永峰,姜军,任国胜,等.乳腺疾病腔镜手术技术操作指南(2016版)[J/CD].中华乳腺病杂志(电子版),2016,10(4):193-198.
[6]邵超,张晶晶,凌飞海.经乳晕切口治疗乳腺良性疾病中麦默通微创旋切系统与传统手术的临床效果对比[J].实用医学杂志,2015,31(7):1 142-1 144.
[7]苏汉友.经腋前线单切口腔镜辅助乳腺纤维瘤手术与常规手术的比较[J].世界最新医学信息文摘,2017,17(38):70-71.
[8] Osanai T,Nihei Z,Ichikawa W,et al.Endoscopic resection of benign breast tumors:retromammary space approach[J].Surg Laparosc Endosc Percutan Tech,2002,12(2):100-103.
[9]贺功建.乳腺腔镜经腋下小切口行乳腺癌保乳术疗效观察[J].现代医药卫生,2016,32(5):755-756.
[10]关山,王宇,张开通,等.应用皮肤悬吊系统腔镜下保留乳头乳晕乳腺切除即刻乳房重建[J].中华外科杂志,2017,55(2):126-129.
[11]骆成玉.乳腔镜在乳腺外科手术中的应用现状[J/CD].中华乳腺病杂志(电子版),2008,2(6):620-625.
[12]代明盛,赵伟军,罗钧刚,等.腔镜下手术切除乳腺良性肿瘤的体会[J].中国现代医,2018,56(1):52-55.
[13]李晨.腔镜下行乳腺大纤维腺瘤切除术的临床效果[J].广西医学,2017,39(7):983-986.
[14]刘忠波.乳腔镜微小隐蔽切口切除乳腺良性肿块的临床探讨[J].中国处方药,2015,13(7):97-98.
[2]王品,吴剑,郭慧敏,等.经腋窝腔镜切除与传统乳晕切口手术治疗男性乳腺发育症的临床对照观察[J].中国美容整形外科杂志,2018,29(7):395-398.
[3] Ordaz DL,Thompson JK.Gynecomastia and psychological functioning:a review of the literature[J]. Body Image,2015,15:141-148.
[4]吴春芝.乳房良性病变乳腔镜改良手术53例临床观察[J].蚌埠医学院学报,2017,42(4):474-476.
[5]刘永峰,姜军,任国胜,等.乳腺疾病腔镜手术技术操作指南(2016版)[J/CD].中华乳腺病杂志(电子版),2016,10(4):193-198.
[6]邵超,张晶晶,凌飞海.经乳晕切口治疗乳腺良性疾病中麦默通微创旋切系统与传统手术的临床效果对比[J].实用医学杂志,2015,31(7):1 142-1 144.
[7]苏汉友.经腋前线单切口腔镜辅助乳腺纤维瘤手术与常规手术的比较[J].世界最新医学信息文摘,2017,17(38):70-71.
[8] Osanai T,Nihei Z,Ichikawa W,et al.Endoscopic resection of benign breast tumors:retromammary space approach[J].Surg Laparosc Endosc Percutan Tech,2002,12(2):100-103.
[9]贺功建.乳腺腔镜经腋下小切口行乳腺癌保乳术疗效观察[J].现代医药卫生,2016,32(5):755-756.
[10]关山,王宇,张开通,等.应用皮肤悬吊系统腔镜下保留乳头乳晕乳腺切除即刻乳房重建[J].中华外科杂志,2017,55(2):126-129.
[11]骆成玉.乳腔镜在乳腺外科手术中的应用现状[J/CD].中华乳腺病杂志(电子版),2008,2(6):620-625.
[12]代明盛,赵伟军,罗钧刚,等.腔镜下手术切除乳腺良性肿瘤的体会[J].中国现代医,2018,56(1):52-55.
[13]李晨.腔镜下行乳腺大纤维腺瘤切除术的临床效果[J].广西医学,2017,39(7):983-986.
[14]刘忠波.乳腔镜微小隐蔽切口切除乳腺良性肿块的临床探讨[J].中国处方药,2015,13(7):97-98.