水平式乳腺旋切切除乳腺表浅良性肿物的可行性  

Feasibility Study of Horizontal Mastectomy With Rotary Cutting for Superficial Benign Tumor Excision

作　　者：宋仁凤 崔建春 俞学伟 刘政帅 张颖 费翔 李立 Song Renfeng;Cui Jianchun;Yu Xuewei(Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University, Liaoning Provincial People’s Hospital, Shenyang 110015, China)

机构地区：[1]中国医科大学人民医院辽宁省人民医院甲状腺乳腺外科,沈阳110015 [2]青海省西宁市湟中区第一人民医院普外科,西宁811600 [3]辽宁省丹东凤城凤凰医院普外科,丹东1181O0

出　　处：《中国微创外科杂志》2020年第12期1106-1110,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：辽宁省基层卫生计生适宜技术推广项目(辽卫传2017-284号-15);西宁市第二批“引才聚555计划”柔性引进领军人才(宁人才字2019-4号)。

摘　　要：目的探讨水平式乳腺旋切技术切除肿物上缘与皮肤距离≤1.0 cm浅表良性乳腺肿瘤的可行性。方法2018年7月~2019年6月,采用水平式旋切(旋切刀槽在肿物的水平正侧方,超声探头与旋切刀槽垂直)乳腺表浅良性肿物69例,并与2017年7月~2018年6月传统垂直式旋切(旋切刀槽在肿物的正下方,超声探头与旋切刀槽平行)33例进行比较,比较2组手术时间、术中出血量、术后皮肤瘀斑、皮肤破损和肿物残留情况。结果水平组手术时间明显短于传统组[(7.7±1.1)min vs.(9.5±1.3)min,t=-7.458,P=0.000];皮肤破损明显少于传统组(0例vs.3例,P=0.032)。2组术中出血、术后皮肤瘀斑和术后6个月肿物残留差异无显著性[(6.0±1.3)ml vs.(6.5±1.5)ml,t=-1.853,P=0.067;4例vs.2例,χ^2=0.000,P=1.000;0例vs.2例,P=0.103]。97例术后随访6~30个月,(16.5±4.5)月,复查超声2组均未再见残留和复发。结论对于乳腺浅表良性肿物,水平式乳腺旋切技术较传统垂直式乳腺旋切技术能够有效避免皮肤损伤,缩短手术时间,有一定的推广应用价值。Objective To investigate the feasibility of horizontal mastectomy with rotary cutting for excision of superficial benign breast tumors with distance between the upper edge of the tumor and the skin≤1.0 cm.Methods A total of 69 cases of horizontal rotary cutting(the rotary cutting knife groove was on lateral side of the tumor and the ultrasonic probe was perpendicular to the rotary cutter groove)from July 2018 to June 2019 were compared with 33 cases of traditional vertical rotary cutting(the rotary knife groove was directly below the tumor and the ultrasonic probe was parallel to the rotary cutting knife groove)from July 2017 to June 2018.The operation time,intraoperative blood loss,postoperative skin ecchymosis,skin damage,and residual tumor were compared between the two groups.Results The operation time of the horizontal group was significantly shorter than that of the traditional group[(7.7±1.1)min vs.(9.5±1.3),t=-7.458,P=0.000].The skin damage in the horizontal group was significantly less than that in the traditional group(0 vs.3 cases,P=0.032).However,there were no significant differences in the intraoperative bleeding,postoperative skin ecchymosis and residual rate of tumor 6 months after surgery between the two groups[(6.0±1.3)ml vs.(6.5±1.5)ml,t=-1.853,P=0.067;4 cases vs.2 cases,χ^2=0.000,P=1.000;0 vs.2 cases,P=0.103].A total of 97 patients were followed up for 6-30 months[(16.5±4.5)months]after operation,and there was no residual tumor or recurrence.Conclusion Compared with traditional vertical mastectomy technique,horizontal mastectomy with rotary cutting technique can effectively avoid skin damage and shorten the operation time,which has certain value of promotion and application.

关 键 词：三维立体定位 水平式旋切 乳腺肿物 

分 类 号：R73[医药卫生—肿瘤]