乳房大体积肿物微创旋切的可行性研究  

Feasibility of Mammotome Minimally Invasive Vacuum Assisted Biopsy for Large Breast Tumor

作　　者：王宁[1] 陈平[1] 刘军[1] Wang Ning;Chen Ping;Liu Jun(Department of General Surgery, China-Japan Friendship Hospital, Beijing 100029, China)

机构地区：[1]中日友好医院普通外科2部,北京100029

出　　处：《中国微创外科杂志》2020年第11期1016-1018,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨长径>2.5 cm但<5.0 cm的乳腺肿物在超声引导下微创旋切的可行性。方法2016年1月~2018年12月我科对125例>2.5 cm单个乳腺肿物采用强生公司麦默通乳腺微创旋切系统,超声引导下将旋切刀置于肿物后方,自下而上旋切肿物,常规留置引流条,术后绷带加压包扎,3 d拆除绷带。结果肿物旋切时间5~21 min,平均16 min。出血量2~30 ml,中位数10 ml。术后未出现血肿,10例出现皮肤青紫。术后病理:良性叶状肿瘤18例(16例>3.0 cm),纤维腺瘤97例,囊肿8例,腺病瘤2例。125例术后随访5个月~3年,中位时间1.0年。18例良性叶状肿瘤中,11例(>3.0 cm)行开放手术扩切边缘,7例观察,其中2例(>3.0 cm)分别术后第1、2年复发,采用开放手术切除,其余病例未见复发及残留。107例非叶状肿瘤中,1例纤维腺瘤复查时因为术后区域超声诊断为4a级,再次微创切除,病理为术后修复性改变;9例纤维腺瘤因乳房其他区域纤维腺瘤长大再次微创手术;5例切口瘢痕增生,余切口愈合良好。结论>2.5 cm但<3.0 cm肿物可以用微创旋切切除;>3.0 cm肿物因叶状肿瘤概率高,影响病理判断,二次手术概率高,不建议微创旋切或者向患者交代清楚后果后行微创旋切。Objective To evaluate the feasibility of ultrasound guided mammotome minimally invasive vacuum assisted biopsy for breast solitary tumor larger than 2.5 cm and smaller than 5.0 cm.Methods A total of 125 cases of breast solitary tumor larger than 2.5 cm and smaller than 5 cm received ultrasound guided micro-invasive vacuum assisted biopsy in our department between January 2016 and December 2018.The Mamotomme ultrasound-guided vacuum-assisted breast biopsy system was adopted,and an 8G puncture needle was selected.The puncture needle was inserted below the tumor under ultrasound guidance,and then the tumor was removed.Bandage was used to pressurize the wound after procedure and was removed after 3 days.Results The operation time was 5-21 min(mean,16 min).The amount of bleeding was 2-30 ml(median,10 ml).No hematoma occurred.Ecchymosis was found in 10 cases.Among the 125 cases,there were 18 cases of benign phylloid tumors,including 16 cases larger than 3.0 cm,97 cases of fibroadenoma,8 cases of cyst,2 cases of adenosis tumor.The patients were followed up for 5 months-3 years(median,1.0 year).In 18 cases of phylloid tumor,extended resection was performed in 11 cases(>3.0 cm),observation in 7 cases,and recurrence in 2 cases(>3.0 cm previously),and then the open operation was performed.No recurrence or residual tumor was seen in the remaining cases.Among 107 cases of non-phylloid tumors,1 case of fibroadenoma was diagnosed as grade 4a by ultrasound after operation,and the pathology result was recovery change after operation;9 cases of fibroadenoma underwent minimally invasive surgery again because of the growth of fibroadenoma in other regions of the breast;5 cases had scar hyperplasia,and the remaining incision healed well.Conclusion Breast tumors larger than 2.5 cm and smaller than 3.0 cm can be removed by ultrasound-guided mammotome minimally invasive vacuum assisted biopsy,while tumors larger than 3.0 cm should not be recommended due to the higher rate of phylloid tumor,influence to pathological judgment and higher r

关 键 词：微创旋切 乳腺肿物 叶状肿瘤 

分 类 号：R73[医药卫生—肿瘤]