经腋窝非溶脂单孔腔镜在乳房良性肿瘤手术中的应用体会  

Application of Transaxillary Single-Port Laparoscopic Surgery without Liposuction in Treatment of Benign Breast Tumors

作　　者：刘磊[1] 易呈浩 王安安[1] 罗永辉[1] LIU Lei;YI Cheng-hao;WANG An-an;LUO Yong-hui(Department of Breast Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院乳腺外科,南昌330006

出　　处：《南昌大学学报（医学版）》2023年第3期69-73,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨经腋窝行非溶脂单孔腔镜乳房良性肿瘤手术的可行性、安全性及美容效果。方法2022年7—10月对12例女性乳房良性肿瘤患者行经腋窝非溶脂单孔腔镜乳腺手术。观察手术时间、术中出血量、术后引流量、拔管时间、术后病理、术后并发症及美容效果。结果12例手术均成功,无一例中转三孔腔镜手术或开放手术。手术时间33~325 min,平均137 min;术中出血量5~10 mL,平均5.8 mL;术后引流量2~105 mL,平均40.5 mL;拔管时间2~5 d,平均3.6 d。术后病理:乳房纤维腺瘤8例,乳房良性叶状肿瘤2例,胸壁脂肪瘤1例,乳房囊性扩张症1例。术后均未使用阿片类镇痛药物。术后未出现严重并发症及不良后果。术后随访时间4~81 d,平均随访时间45 d,患者创腔及腋窝切口均无不适感,患者对美容效果评分为8~10分,平均9.2分。结论经腋窝非溶脂法单孔腔镜乳腺手术具有切口隐蔽、美容效果好、并发症少等特点,能最大限度满足年轻女性巨大乳腺良性肿瘤患者的美观要求。Objective To investigate the feasibility,safety and cosmetic efficacy of transaxillary single-port laparoscopic surgery without liposuction in the treatment of benign breast tumors.Methods The operation time,intraoperative blood loss,postoperative drainage volume,extubation time,postoperative pathology,postoperative complications and cosmetic efficacy were observed in 12 patients who received transaxillary single-port laparoscopic surgery without liposuction for benign breast tumors from July 2022 to October 2022.Results The procedure was successfully completed in all the patients without conversion to three-port endoscopy or open surgery.The average operation time,intraoperative blood loss,postoperative drainage volume and extubation time were 137 min(range,33 to 325 min),5.8 mL(range,5 to 10 mL),40.5 mL(range,2 to 105 mL)and 3.6 d(range,2 to 5 d),respectively.Postoperative pathological examination showed breast fiber adenoma in 8 cases,benign phyllodes tumor of the breast in 2 cases,lipoma of the chest wall in 1 case,and cystic dilatation of the breast in 1 case.No opioid analgesics were used and no serious complications and adverse consequences were observed after surgery.During an average follow-up of 45 d(range,4 to 81 d),the patients had no discomfort in the wound cavity and axillary incision.The average cosmetic satisfaction score was 9.2(range,8 to 10).Conclusion Transaxillary single-port laparoscopic surgery without liposuction has the characteristics of concealed incision,good cosmetic effect and less complications,and can meet the cosmetic requirements of young female patients with giant benign breast tumors.

关 键 词：乳房良性肿瘤 单孔腔镜手术 经腋窝途径 非溶脂 

分 类 号：R739.9[医药卫生—肿瘤]