Song Ren-Feng, Jiang Yu-Xia, Cui Jian-Chun, Yu Xue-Wei, Gao Yang, Li Li, Pei Xiao-Hua
Department of General Surgery, The First People's Hospital of Huangzhong District, Xining, 811600, People's Republic of China.
Department of Thyroid and Breast Surgery, The Chinese Medicine Hospital of Shexian, Handan, 056400, People's Republic of China.
Int J Gen Med. 2021 Apr 19;14:1379-1387. doi: 10.2147/IJGM.S303183. eCollection 2021.
This study aims to investigate the feasibility of the horizontal rotary-cut technique in the removal of superficial benign breast tumors with a ≤1.0 cm distance between the upper margin of the tumor and the skin.
A total of 69 patients with superficial benign breast tumors received horizontal rotary-cut surgery between July 2018 and June 2019 (horizontal group). The rotary cutter groove was in the true lateral position of the tumor and the ultrasonic probe was vertical to the rotary cutter groove. The patients were compared with 33 patients who underwent the traditional vertical rotary-cut surgery between July 2017 and June 2018 (traditional group) regarding the aspects of operation time, intraoperative bleeding volume, postoperative skin ecchymosis, skin damage, and tumor residue. The rotary cutter groove was directly below the tumor and the ultrasonic probe was parallel to the rotary cutter groove in the traditional vertical rotary-cut surgery.
The operation time in the horizontal group was significantly shorter than in the traditional group (7.7 ± 1.1 minutes vs 9.5 ± 1.3 minutes, with = -7.458 and p = 0.000) and there was significantly less skin damage in the horizontal group than in the traditional group (0 cases vs 3 cases, with p = 0.032). The differences in intraoperative bleeding and postoperative skin ecchymosis between the two groups were not statistically significant (6.0 ± 1.3 mL vs 6.5 ± 1.5 mL, with = -1.853 and p = 0.067; 4 cases vs 2 cases, with = 0.003 and p = 0.958). Ninety-seven patients attended follow-ups for 6-30 (16.5 ± 4.5) months. No residues or recurrences were observed under ultrasound reviews in either group.
In superficial benign breast tumor removal, the horizontal rotary-cut breast technique can help avoid skin injury, shorten the operation time, and reduce tumor residue more effectively compared with the traditional vertical rotary-cut technique. It has certain popularization and application values.
本研究旨在探讨水平旋转切割技术在切除肿瘤上缘与皮肤距离≤1.0 cm的浅表性乳腺良性肿瘤中的可行性。
2018年7月至2019年6月，共有69例浅表性乳腺良性肿瘤患者接受了水平旋转切割手术（水平组）。旋转切割刀槽位于肿瘤的真正外侧位置，超声探头垂直于旋转切割刀槽。将这些患者与2017年7月至2018年6月接受传统垂直旋转切割手术的33例患者（传统组）在手术时间、术中出血量、术后皮肤瘀斑、皮肤损伤和肿瘤残留等方面进行比较。在传统垂直旋转切割手术中，旋转切割刀槽位于肿瘤正下方，超声探头与旋转切割刀槽平行。
水平组的手术时间明显短于传统组（7.7±1.1分钟对9.5±1.3分钟，t=-7.458，p=0.000），且水平组的皮肤损伤明显少于传统组（0例对3例，p=0.032）。两组术中出血量和术后皮肤瘀斑的差异无统计学意义（6.0±1.3 mL对6.5±1.5 mL，t=-1.853，p=0.067；4例对2例，z=0.003，p=0.958）。97例患者进行了6 - 30（16.5±4.5）个月的随访。两组在超声检查下均未观察到残留或复发。
在浅表性乳腺良性肿瘤切除中，与传统垂直旋转切割技术相比，水平旋转切割乳腺技术可有助于避免皮肤损伤，缩短手术时间，并更有效地减少肿瘤残留。它具有一定的推广应用价值。
