两种微创术式治疗男性乳房发育症的比较研究  

Comparative study on surgical treatment of gynecomastia with minimally invasive techniques

作　　者：王忠堂[1,2] 黄小进[3] 李健宁[4,2] 张少军 罗德丰 

机构地区：[1]厦门大学附属中山医院整形美容外科,福建厦门361004 [2]厦门美莱医疗美容门诊部美容外科 [3]厦门大学附属中山医院血管外科 [4]北京大学第三医院成形外科

出　　处：《中国美容医学》2014年第12期958-961,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:评价吸脂联合腺体切除与改良内视镜旋切刀刨削两种微创技术治疗男性乳房发育症的临床疗效。方法:回顾性分析2006年10月~2013年12月手术治疗的49例男性乳腺发育症患者,均为双侧发育,年龄19~46岁,平均22.6岁。其中I型7例,IIa型32例,IIb型10例。负压吸脂联合腺体切除组30例,内视镜旋切刀治疗组19例。结果:两组患者基本达到正常男性胸部外观,无乳头乳晕坏死,切口瘢痕细小。吸脂联合腺体切除组手术时间76.2min(60~110min),并发症发生率23.3%,满意率86.7%;内视镜旋切刀组手术时间45.9min(35~75min),并发症发生率7.7%,满意率94.7%。结论:改良内视镜旋切刀技术较吸脂联合腺体切除治疗I^IIb型男性乳房发育症并发症少,满意度高,省时高效。Objective To assess two minimally invasive treatment for gynecomastia of liposuction combined with ＂pull-through＂ and modified endoscopic cartilage shaving techniques focusing on operative times, complications,and aesthetic results. Methods A retrospective analysis of 49 patients with a mean age of 22.6 years （range, 19 -46 years） undergoing the surgery for bilateral gynecomastia in our departments was referred from October 2006 to December 2013. Overall, 7 cases of Simon＇s grade Ⅰ gynecomastia, 32 with grade Ila and 10 with grade lib were included. Thirty-two cases were treated with liposuction combined with ＂pull-through＂ technique, 19 with modified endoscopic cartilage shaving technique. Results An approximate normal male chest contour profile was achieved in all patients. No wound infection, conspicuous scar, nipple-areola complex necrosis, or nipple sense permanent lost was observed in this series. The mean operative time was 76.2 minutes （range, 60-110 minutes） vs 45.9 minutes （range, 35-75 minutes）（P=0.000）, in patients using liposuction combined with ＂pull-through＂ technique and endoscopic cartilage shaving technique, respectively. Perioperative complication rates differed within operative techniques, liposuction combined with ＂pull-through＂ technique with 23.3% ,vs endoscopic cartilage shaving technique with 7.7% （P =0.049）. With regard to cosmetic results,the postoperative satisfactory rates in liposuction combined with ＂pull-through＂ group and endoscopic cartilage shaving group were 86.7% and 94.7% （P=0.198）, respectively. Conclusion Modified suction-assisted endoscopic cartilage shaving technique provides a good aesthetic outcome in patients with Simon grades Ⅰ to Ⅱ b gynecomastia, with fewer complications,as well as simpler operation and higher efficiency.

关 键 词：男性乳房发育症 脂肪切除术 乳房切除术 内视镜旋切刀技术 美容效果 术后并发症 

分 类 号：R655.8[医药卫生—外科学]