Thurley P, Evans A, Hamilton L, James J, Wilson R
The Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Clin Radiol. 2009 Apr;64(4):381-5. doi: 10.1016/j.crad.2008.09.013. Epub 2008 Dec 16.
To establish the efficacy, complications, and patient satisfaction for vacuum-assisted biopsy (VAB) excision of fibroadenomas.
All patients referred for VAB of benign lesions from 11 December 2002 to 30 November 2006 were identified prospectively, and the following data were recorded: age, histology, lesion size, and completeness of excision. A questionnaire was sent at least a year after the procedure to assess pain, complications, residual palpable lesions, and cosmetic result.
One hundred and thirty-four patients were referred for VAB, 81 had fibroadenomas. Fifty-nine percent replied to the questionnaire. Fifty-four percent of patients reported no pain during the procedure, 8% rated their pain at > or =3/10. Thirty-two percent had no pain the week after the procedure, 55% had pain > or =3/10. Seventy-nine percent had no palpable mass at the site of the original lesion. Ninety-four percent would recommend the procedure to others and would prefer further VAB to surgery. Bruising was common, one patient required aspiration of a haematoma. Six percent developed infections, all resolved with antibiotic therapy. Eighty-five percent of patients were completely satisfied with the cosmetic result. Interval ultrasound was performed in 36 patients. A palpable mass was present in 11%, a non-palpable mass in 19%, and no mass in 70%.
VAB excision is well-tolerated, safe, and popular with a high initial success rate for fibroadenomas. Bruising and pain are common the week after the procedure.
确定真空辅助活检(VAB)切除纤维瘤的疗效、并发症及患者满意度。
前瞻性纳入2002年12月11日至2006年11月30日期间因良性病变接受VAB的所有患者,并记录以下数据:年龄、组织学、病变大小及切除完整性。术后至少一年发放问卷,评估疼痛、并发症、可触及的残留病变及美容效果。
134例患者接受VAB,其中81例为纤维瘤。59%的患者回复了问卷。54%的患者报告术中无疼痛,8%的患者将疼痛评为≥3/10。32%的患者术后一周无疼痛,55%的患者疼痛≥3/10。79%的患者在原病变部位未触及肿块。94%的患者会向他人推荐该手术,并更倾向于进一步接受VAB而非手术。瘀斑常见,1例患者需要抽吸血肿。6%的患者发生感染,均经抗生素治疗后痊愈。85%的患者对美容效果完全满意。36例患者接受了间隔期超声检查。11%的患者可触及肿块,19%的患者不可触及肿块,70%的患者未发现肿块。
VAB切除耐受性良好、安全且受欢迎,对纤维瘤的初始成功率较高。术后一周瘀斑和疼痛常见。