机器人辅助免溶脂技术在男性乳腺发育手术中的应用  

Application of robot-assisted non-lipolysis technique on gynecomastia

作　　者：刘源源 朱见 刘长瑞 王丹[2] 曹宪姣 刘懿心 翟东亮 贺青卿[2] LIU Yuanyuan;ZHU Jian;LIU Changrui;WANG Dan;CAO Xianjiao;LIU Yixin;ZHAI Dongliang;HE Qingqing(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250011,China;Department of Thyroid and Breast Surgery,the 960th Hospital of PLA Joint Logistic Support Force,Jinan 250031,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250011 [2]中国人民解放军联勤保障部队第九六○医院甲状腺乳腺外科,山东济南250031

出　　处：《机器人外科学杂志(中英文)》2025年第1期95-100,共6页Chinese Journal of Robotic Surgery

基　　金：中国人民解放军联勤保障部队重点学科项目(202204011069)。

摘　　要：目的:探讨经腋窝入路机器人辅助免溶脂乳房皮下腺体切除术在治疗男性乳腺发育症中的可行性、安全性和有效性。方法:回顾性分析2021年10月—2023年10月中国人民解放军联勤保障部队第九六○医院行机器人辅助乳房皮下腺体切除术的52例男性乳腺发育症患者的临床资料,根据是否采用溶脂技术分为机器人辅助免溶脂组(观察组,n=20)和机器人辅助溶脂组(对照组,n=32)。统计、分析两组患者的一般资料及手术情况,并随访两组患者术后并发症发生情况和术后美容效果满意度。结果:所有患者均顺利完成手术。两组患者的一般临床资料(年龄、BMI、病程、血清泌乳素水平和Simon分级)比较,差异无统计学意义(P>0.05),两组患者的围手术期指标(双侧手术时间、术中出血量、术后引流量、术后引流管留置时间和住院时间)比较,差异有统计学意义(P<0.05)。两组患者术后24h疼痛评分及术后并发症发生情况(乳头乳晕坏死、皮下血肿、皮下血清肿、皮肤感染和脂肪液化)比较,差异无统计学意义(P>0.05)。两组患者对术后美容效果满意度的评分(胸部整体外观、乳头乳晕及术区皮肤感觉和整体满意度)比较,差异有统计学意义(P<0.05)。结论:经腋窝入路机器人辅助免溶脂乳房皮下腺体切除术治疗男性乳腺发育症是可行、安全、有效的,且美容效果满意度高。Objective:To explore the feasibility,safety,and effectiveness of transaxillary robot-assisted non-lipolysis subcutaneous mastectomy in the treatment of gynecomastia.Methods:52 patients with gynecomastia who underwent robot-assisted subcutaneous mastectomy in the 960th Hospital of PLA Joint Logistic Support Force from Oct.2021 to Oct.2023 were selected and divided into the observation group(robot-assisted non-lipolysis group,n=20)and the control group(robot-assisted lipolysis group,n=32).A retrospective analysis was performed.The general data and surgical conditions of the two groups were statistically analyzed,and they were followed up for the postoperative cosmetic satisfaction and occurrence of complications.Results:All the surgeries were completed successfully.There was no significant difference in the general data(age,BMI,disease duration,serum prolactin level,and Simon grading)between the two groups(P>0.05),and the perioperative indicators(bilateral operative time,intraoperative bleeding,postoperative drainage,postoperative drain retention time,and hospitalization time)between the two groups were statistically different(P<0.05).Comparison of 24h postoperative pain scores and the occurrence of postoperative complications(nipple areola necrosis,subcutaneous hematoma,subcutaneous seroma,skin infection and fat liquefaction)between the two groups showed no significant difference(P>0.05).The scores of patients’satisfaction with postoperative cosmetic results(overall appearance of the chest,skin sensation of the nipple areola and operative area,and overall satisfaction)between the two groups was statistically different(P<0.05).Conclusion:For gynecomastia,robotic-assisted non-lipolysis subcutaneous mastectomy with a transaxillary approach is practical,secure,and highly cosmetical pleasing.

关 键 词：男性乳腺发育症 机器人辅助手术 免溶脂技术 乳房皮下腺体切除术 

分 类 号：R655.8[医药卫生—外科学]