| 摘要: |
| ［摘要］ 目的 分析经腋窝入路单孔充气法腔镜下乳腺良性肿瘤切除术的可行性和临床效果。方法 回顾性分析2021年6月至2023年7月在佛山市南海区人民医院乳腺外科行经腋窝入路单孔腔镜下乳腺良性肿瘤切除术62例患者的临床病理资料，分析总结手术成功率、切除肿瘤个数、手术时间、术中情况、术后并发症和临床效果。结果 62例患者均顺利完成手术，共切除144个良性肿瘤，平均（2.1±1.2）个。单侧乳房平均手术操作时间为（67.0±3.2）min，双侧乳房平均手术操作时间为（111.0±7.6）min。单个肿瘤切除时间：外侧象限［（27.0±1.9）min］较位于内侧象限［（20.0±2.5）min］长，差异有统计学意义（t=10.768，P<0.001）；肿瘤直径>5.0 cm者为（25.0±1.8）min，较肿瘤直径2.0～5.0 cm者的（30.0±2.9）min短，差异有统计学意义（t=6.781，P<0.001）。62例患者术中出血量均小于20 ml，无术后出血、切口感染及愈合不良病例。术后第1天14例出现10 ml以上的局部积液，抽液加压包扎后消失。3例出现患侧上肢功能障碍，经针灸理疗3～4周后恢复。随访6个月，无一例肿瘤复发，患者满意度为100.00%。结论 经腋窝入路单孔充气法腔镜下乳腺良性肿瘤切除术，是治疗乳腺疾病的一种行之有效的新技术，不仅可以完整地切除病灶，而且术后瘢痕隐蔽，美容效果好。 |
| 关键词: 腔镜辅助乳腺手术 乳腺良性肿瘤 腋窝入路 |
| DOI：10.3969/j.issn.1674-3806.2023.09.03 |
| 分类号:R 737.9 |
| 基金项目:佛山市科技局医学类科技攻关项目（编号：2220001004005）；佛山市“十四五”高水平医学重点专科建设项目（编号：佛卫函〔2021〕107号） |
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| Transaxillary approach single-port laparoscopic resection of benign breast tumors: a new technology analysis report from a primary hospital |
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YAO Cheng-cai, LIU Chang-chun, HUANG Wen-jian
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Department of Breast Surgery, the Sixth Affiliated Hospital of South China University of Technology, Foshan Nanhai District People′s Hospital, Guangdong 528225, China
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| Abstract: |
| ［Abstract］ Objective To analyze the feasibility and clinical effects of transaxillary approach single-port pneumatic lumpectomy for benign breast tumors. Methods The clinicopathological data of 62 patients who underwent transaxillary approach single-port pneumatic lumpectomy for benign breast tumors in the Department of Breast Surgery of Foshan Nanhai District People′s Hospital from June 2021 to July 2023 were retrospectively analyzed and the success rate of operation, number of resected tumors, operation time,intraoperative conditions, postoperative complications, and clinical outcomes were analyzed and summarized. Results All of the 62 patients were successfully operated, and a total of 144 benign tumors were resected in the 62 patients with an average of (2.1±1.2)tumors. The average operation time was (67.0±3.2)minutes for unilateral breast and (111.0±7.6)minutes for bilateral breasts. The time to resect a single tumor in the lateral quadrant［(27.0±1.9)minutes］ was significantly longer than that in the medial quadrant［(20.0±2.5)minutes］(t=10.768, P<0.001). The time to resect a single tumor in the diameter of more than 5.0 cm［(25.0±1.8)minutes］ was significantly shorter than that in the diameter between 2.0 cm and 5.0 cm［(30.0±2.9)minutes］(t= 6.781, P<0.001). The intraoperative bleeding volume was less than 20 ml in all the 62 patients, and there were no cases of postoperative bleeding, incision infection and poor healing. Among the 62 patients, 14 patients had local effusion of more than 10 ml on the first day after surgery, which disappeared after fluid aspiration and pressure dressing; three patients had upper extremity dysfunction in their lesion sides, which recovered after 3-4 weeks of acupuncture and physiotherapy; no patients had tumor recurrence after a follow-up of 6 months, and the patients′ satisfaction rate was 100.00%. Conclusion Transaxillary approach single-port pneumatic endoscopic-assisted lumpectomy for benign breast tumors is a new and effective technique for the treatment of breast diseases. It can not only completely remove the lesions, but also conceal the scars with good cosmetic results after surgery. |
| Key words: Laparoscopic-assisted breast surgery Benign breast tumor Axillary approach |
