Princess Alexandra Hospital, Brisbane, Australia.
University of Queensland, Brisbane, Australia.
World J Surg. 2020 Mar;44(3):819-824. doi: 10.1007/s00268-019-05266-7.
Image-guided interventional techniques such as vacuum-assisted biopsy are being increasingly utilised in the diagnosis and management of breast conditions. The purpose of this study was to report the outcome of a series of vacuum-assisted biopsies and vacuum-assisted excisions performed by specialist breast surgeons in a largely outpatient setting.
An Australian multicentre trial of ultrasound-guided surgeon-performed vacuum-assisted biopsy (VAB) and vacuum-assisted excision (VAE) of breast lesions was conducted involving three surgeons in three participating centres. VAEs were performed for presumed or proven benign breast lesions only.
A total of 225 surgeon-performed ultrasound-guided vacuum-assisted procedures were undertaken in 197 patients. Of the 225 VAB procedures, 51 (22.7%) were performed as diagnostic cores and 174 (77.3%) were undertaken as core excisions. Of the 174 VAE procedures undertaken with intent of completely excising the lesion, successful excision of the lesion was achieved in 165 of these cases (94.8%), with complete excision being judged by the absence of any lesion seen on ultrasound following the procedure or the absence of the lesion on a subsequent interval ultrasound examination. A total of 199 procedures were performed in the outpatients setting under local anaesthesia, and 26 procedures were performed in an operating theatre setting under neurolept anaesthesia. The average size of lesions was 19.3 mm in the diagnostic core group and 10.6 mm in the core excision group. The average time for either procedure was approximately 14 min.
Specialist breast surgeons familiar with ultrasound can be readily upskilled to perform vacuum-assisted procedures safely and expeditiously. VAE represents a minimally invasive method of breast lesion management and is a technique with which breast surgeons should become adept.
影像引导下的介入技术，如真空辅助活检，在乳腺疾病的诊断和治疗中越来越多地被应用。本研究的目的是报告一组在大部分门诊环境下由乳腺外科专家进行的真空辅助活检（VAB）和真空辅助切除（VAE）的结果。
一项涉及 3 名外科医生在 3 个参与中心进行的超声引导下外科医生操作的真空辅助活检（VAB）和真空辅助切除（VAE）的澳大利亚多中心试验，VAEs 仅用于疑似或已证实的良性乳腺病变。
在 197 名患者中，共进行了 225 例由外科医生操作的超声引导下真空辅助手术。在 225 例 VAB 中，51 例（22.7%）为诊断性核心，174 例（77.3%）为核心切除。在 174 例旨在完全切除病变的 VAE 中，165 例（94.8%）成功切除病变，通过术后超声检查未见任何病变或随后的间隔超声检查未见病变来判断完全切除。199 例在门诊环境下局部麻醉下进行，26 例在手术室环境下神经安定麻醉下进行。诊断性核心组的病变平均大小为 19.3 毫米，核心切除组为 10.6 毫米。两种手术的平均时间约为 14 分钟。
熟悉超声的乳腺外科专家可以很容易地获得技能，安全、迅速地进行真空辅助操作。VAE 是一种微创的乳腺病变管理方法，是乳腺外科医生应该掌握的技术。
