Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
Surgery. 2019 Nov;166(5):934-939. doi: 10.1016/j.surg.2019.04.032. Epub 2019 Jun 24.
Gynecomastia is the most common benign enlargement of the mammary gland and adipose tissue in males. Because a feminine-looking chest contour can bring severe psychologic burden to patients, subcutaneous mastectomy has become the standard treatment for this condition. Conventional open surgery causes conspicuous scarring that may affect the appearance of the breast. We provide a novel surgical operative for the treatment of gynecomastia.
With approval from our institutional ethics committee and written informed consent, 22 patients with 33 abnormally hyperplastic breasts were enrolled at The First Affiliated Hospital with Nanjing Medical University between June 2016 and September 2018. Vacuum-assisted minimally invasive surgery was performed under general anesthesia. Patients were followed up with physical examination and ultrasonography.
Vacuum-assisted minimally invasive mastectomy was performed successfully in all cases, with no residual glands or adipose tissue observed on ultrasonography. The operation had a mean duration of 73.5 minutes per side, ranging from 40 to 102 minutes. An average of 320 specimens were excised from each side with mean blood loss of 34 mL. Of these 33 operative sides, 2 complications occurred, but satisfactory chest contour was attained eventually in all patients. All patients were satisfied with their cosmetic outcome, graded as excellent by 22 patients (100%). Redundant skin was observed in 1 patient at 1 month postoperatively, whose breast, defined as graded III, was the largest before operation.
Vacuum-assisted, minimally invasive mastectomy is a feasible approach for the treatment of gynecomastia with acceptable complications.
男性乳房组织和脂肪组织的良性增大中最常见的是男性乳房发育症。由于女性化的胸部轮廓会给患者带来严重的心理负担,因此皮下乳房切除术已成为治疗这种疾病的标准方法。传统的开放式手术会导致明显的疤痕,可能会影响乳房的外观。我们提供了一种新的手术方法来治疗男性乳房发育症。
在南京医科大学第一附属医院,我们获得机构伦理委员会的批准并获得书面知情同意后,于 2016 年 6 月至 2018 年 9 月期间纳入了 22 例 33 个异常增生乳房的患者。在全身麻醉下进行了真空辅助微创乳房切除术。通过体格检查和超声检查对患者进行随访。
所有病例均成功完成了真空辅助微创乳房切除术,超声检查未见残留腺体或脂肪组织。手术每侧的平均持续时间为 73.5 分钟,范围为 40 至 102 分钟。每侧平均切除 320 个标本,平均失血量为 34 毫升。在这 33 个手术侧中,有 2 例出现并发症,但最终所有患者均获得了满意的胸部轮廓。所有患者对他们的美容效果都非常满意,22 例患者(100%)评为优秀。1 例患者在术后 1 个月出现多余皮肤,其乳房在手术前是最大的,被评为 III 级。
真空辅助微创乳房切除术是治疗男性乳房发育症的一种可行方法,并发症可接受。