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内镜视频辅助乳腺手术:手术方法及短期效果

Endoscopic video-assisted breast surgery: procedures and short-term results.

作者信息

Yamashita Koji, Shimizu Kazuo

机构信息

Department of Surgery, Musashikosugi Hospital, Nippon Medical School, Kawasaki, Kanagawa, Japan.

出版信息

J Nippon Med Sch. 2006 Aug;73(4):193-202. doi: 10.1272/jnms.73.193.

Abstract

BACKGROUND

We devised a new endoscopic operation for breast diseases. We report the aesthetic and treatment results of this procedure.

METHODS

A 2.5-cm axillary skin incision was made for a single approaching port, and a working space was created by retraction. Under video assistance, we resected the mammary gland partially or totally, and in the case of malignant diseases we also performed a sentinel lymph node biopsy and dissected axillary lymph nodes (levels I and II).

RESULTS

From December 2001 through April 2005, we performed endoscopic video-assisted breast surgery (VABS) in 100 patients with breast diseases. The diseases were benign in 18 patients and malignant in 82 patients. Of the malignant diseases, 80 underwent breast-conserving surgery and 2 underwent skin-sparing mastectomy. There was no significant difference in operation time, blood loss, or blood examinations related with the acute phase reaction between VABS and conventional breast-conserving procedures. All surgical margins were negative on examination of permanent histological preparations. The wounds healed without noticeable scarring. The original shapes of the breast were preserved. All patients expressed their great satisfaction with VABS.

CONCLUSIONS

VABS can be considered as a surgical option and can provide aesthetic advantages for patients with breast disease.

摘要

背景

我们设计了一种用于乳腺疾病的新型内镜手术。我们报告了该手术的美学效果和治疗结果。

方法

做一个2.5厘米的腋窝皮肤切口作为单个进镜口,通过牵拉创建一个操作空间。在视频辅助下,我们部分或全部切除乳腺,对于恶性疾病,我们还进行了前哨淋巴结活检并清扫腋窝淋巴结(Ⅰ级和Ⅱ级)。

结果

从2001年12月至2005年4月,我们对100例乳腺疾病患者进行了内镜视频辅助乳腺手术(VABS)。其中18例为良性疾病,82例为恶性疾病。在恶性疾病中,80例行保乳手术,2例行保留皮肤的乳房切除术。VABS与传统保乳手术在手术时间、失血量或与急性期反应相关的血液检查方面无显著差异。所有手术切缘在永久组织学切片检查中均为阴性。伤口愈合后无明显瘢痕。乳房的原始形状得以保留。所有患者对VABS都表示非常满意。

结论

VABS可被视为一种手术选择,可为乳腺疾病患者提供美学优势。

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