Liu Shu, Zou Jia-Li, Zhou Fu-Lin, Fang Yan-Man
Department of Breast Surgery, Guiyang Maternal and Child Healthcare Hospital/Guiyang Minimally Invasive Breast Center, Guiyang 550003, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Aug 20;37(8):1121-1125. doi: 10.3969/j.issn.1673-4254.2017.08.20.
To assess the clinical value of ultrasound-guided vacuum-assisted Mammotome (MMT) system for surgical resection of benign breast disease.
This retrospective study was conducted among 1267 patients who underwent minimally invasive surgery with ultrasound-guided MMT system for benign breast disease at our center between January, 2009 and January, 2014. The resection rate, incidence of complication, recurrence rate, patients' satisfaction, clinical follow-up results and risk factors were analyzed. The patients were followed up at 1 month, 6 months and every 6 months thereafter for up to 2 years with a median follow-up of 22 months.
Of the total of 1267 patients, 1259 (99.36%) had complete resection of the breast lesions, and residual lesions were found in 8 cases 1 month after the operation. The resection rate was significantly associated with lesion size (P=0.003) but not with the patients'age, pathology, BI-RADS classification, or the number or location of the lesions (P>0.05). Eighty-nine (7.02%) patients showed postoperative complications, and hematoma occurred in 70 (5.52%) patients after the operation. The complication rate was significantly associated with the number and location of lesions (P=0.000) but not with age, pathology, BI-RADS classification or the lesion size (P>0.05). A total of 193 (15.23%) patients had recurrence after the operation, including 65 (5.13%) with in situ recurrence and 128 (10.1%) with new lesions. The recurrence rate was significantly associated with the number and size of lesions (P=0.000) but not with age, pathology, BI-RADS classification or location of lesions(P>0.05). Six patients were not satisfied with the appearance of the incision, and the overall satisfaction rate of the patients was 99.52%.
s Ultrasound-guided vacuum-assisted MMT excision is a safe and effective procedure for benign breast disease with a low surgical complication rate, a high resection rate and a low recurrence rate. This technique results in good postoperative appearance for treatment of benign and high-risk breast lesions, especially multiple benign breast lesions.
评估超声引导下真空辅助麦默通（MMT）系统手术切除乳腺良性疾病的临床价值。
本回顾性研究纳入了2009年1月至2014年1月期间在我院中心接受超声引导下MMT系统微创手术治疗乳腺良性疾病的1267例患者。分析切除率、并发症发生率、复发率、患者满意度、临床随访结果及危险因素。患者在术后1个月、6个月及此后每6个月进行随访，最长随访2年，中位随访时间为22个月。
1267例患者中，1259例（99.36%）乳腺病变完全切除，术后1个月有8例发现残留病变。切除率与病变大小显著相关（P = 0.003），但与患者年龄、病理、BI-RADS分类或病变数量及位置无关（P>0.05）。89例（7.02%）患者出现术后并发症，术后70例（5.52%）患者发生血肿。并发症发生率与病变数量及位置显著相关（P = 0.000），但与年龄、病理、BI-RADS分类或病变大小无关（P>0.05）。共有193例（15.23%）患者术后复发，其中原位复发65例（5.13%），新发病变128例（10.1%）。复发率与病变数量及大小显著相关（P = 0.000），但与年龄、病理、BI-RADS分类或病变位置无关（P>0.05）。6例患者对切口外观不满意，患者总体满意度为99.52%。
超声引导下真空辅助MMT切除术治疗乳腺良性疾病安全有效，手术并发症发生率低，切除率高，复发率低。该技术治疗乳腺良性及高危病变，尤其是多发性乳腺良性病变，术后外观良好。
