经腋窝单切口腔镜手术治疗乳腺疾病34例分析  

Analysis of 34 cases of breast diseases treated by endoscopic surgery through a single axillary incision

作　　者：杨五耀 胡时栋 孙嘉鸿 陈玉辉 张丽萍 宋楠 王建东 YANG Wu-yao;HU Shi-dong;SUN Jia-hong;WANG Jian-dong(Department of General Surgery,the First Medical Center of the Chinese PLA General Hospital,Bejing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心普通外科医学部,北京100853

出　　处：《中国实用外科杂志》2024年第11期1281-1285,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.62476285)。

摘　　要：目的探讨经腋窝单切口腔镜手术在乳腺疾病外科治疗应用的临床效果。方法回顾性分析2022年11月至2024年7月于中国人民解放军总医院第一医学中心收治的经腋窝单切口腔镜乳腺手术的34例乳腺疾病病人的临床病理、手术及随访等资料。结果病人平均年龄(38.97±11.67)岁,男性3例,女性31例。良性疾病12例(1例良性叶状肿瘤,8例纤维瘤,3例男性乳腺发育症),恶性肿瘤22例(5例导管原位癌,16例浸润性癌,1例新辅助治疗后病理未见癌细胞)。34例病人均顺利完成经腋窝单切口腔镜乳腺手术,无中途转为开放手术病例。所有病人的平均手术时间为(202.56±62.03)min,清扫淋巴结0(0,9)个,阳性淋巴结0(0,0)个,出血量为50(20,50)mL,术后第1天引流量为80(50,145)mL,术后第2天引流量为(78.00±46.32)m L,术后第3天引流量为50(35,100)mL。术后出血1例,采用局部加压包扎后出血停止。中位随访时间9个月,恶性病例术后随访未见复发转移,1例纤维腺瘤病人术后发现同侧良性结节。术后随访期间病人对外形满意度较高。结论经腋窝单切口乳腺手术安全可行,美容效果较好,病人满意度较高,具有潜在的临床推广价值。Objective To explore the clinical effect of endoscopic breast surgery through a single axillary incision.Methods The basic information,operation and follow-up data of 34 patients with breast diseases who were received endoscopic breast surgery through a single axillary incision at the First Medical Center of the Chinese PLA General Hospital from November 2022 to July 2024 were retrospectively analyzed.Results The average age of all the 34 patients was(38.97±11.67)years old,with 3 males and 31 females.There were 12 cases of benign diseases(including 1 case of benign lobe tumor,8 cases of fibroma,and 3 cases of gynecomastia)and 22 cases of malignant tumors(including 5 cases of ductal carcinoma in situ,16 cases of invasive carcinoma,and 1 case with no pathological findings after neoadjuvant therapy).All the 34 patients successfully received endoscopic breast surgery through a single axillary incision,with no cases transferring to open surgery.The mean operation time of all patients was(202.56±62.03)min.0(0,9)lymph nodes were cleared,0(0,0)positive lymph nodes were cleared,and the blood loss was 50(20,50)mL.The drainage volume was 80(50,145)mL on the first day after surgery,(78.00±46.32)mL on the second day,and 50(35,100)mL on the third day.Postoperative hemorrhage in 1 case was stopped after local pressure dressing.The median follow-up time was 9 months,and no recurrence or metastasis was found in malignant cases.Ipsilateral benign nodules were found in 1 fibroadenoma patient.The patients had higher satisfaction with the appearance during the postoperative follow-up.Conclusion The endoscopic breast surgery through a single axillary incision is safe and feasible,with good cosmetic effect and high patient satisfaction,which has potential clinical promotion value.

关 键 词：腋窝切口 腔镜 乳腺疾病 微创 

分 类 号：R6[医药卫生—外科学]