Fei Xiang, Song Renfeng, Yu Xuewei, Zhang Siyuan, Zhang Ying, Gao Yang, Bi Dongning, Yao Shengsheng, Cui Jianchun
Department of Thyroid and Breast Surgery, People's Hospital of China Medical University (Liaoning Provincial People's Hospital), Shenyang, 110016, China.
Department of General Surgery, First People's Hospital of Huangzhong District, Xining, Qinghai Province, Xining, 056400, China.
Heliyon. 2023 Feb 7;9(2):e13537. doi: 10.1016/j.heliyon.2023.e13537. eCollection 2023 Feb.
To explore the clinical outcomes of the complete process management of horizontal rotational resection of a breast mass.
A retrospective study was conducted involving 638 patients who underwent horizontal rotational resection of breast tissue in the Department of Thyroid and Breast Surgery of the People's Hospital of China Medical University from August 2018 to August 2020 using the ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification of 4A and below. These patients were divided into the experimental group and the control group based on whether the surgery had been performed following the order of the complete process management. The time cutoff point for the two groups was June 2019. The propensity score matching method was used to implement 1:1 ratio matching according to age, mass size, location, ultrasound BI-RADS classification, and breast size (measured by basal diameter), and the patients in the two groups were compared for the duration of surgery (the time needed to performed the three-step 3D positioning), postoperative skin hematoma and ecchymosis, postoperative pathological malignancy rate, residual rate of the mass, and satisfaction rate.
After 278 pairs were matched, no statistically significant differences were found between the two groups in terms of demographics (P > 0.05). The duration of surgery in the experimental group was significantly shorter compared with the control group (7.90 ± 2.18 min vs. 10.20 ± 5.99 min, respectively; < 0.05); the satisfaction score in the experimental group (8.33 ± 1.36) was higher compared with the control group (6.48 ± 1.22) ( < 0.05); the malignant and residual rates of mass in the experimental group were lower than those in the control group, i.e., 6 vs. 21 cases ( < 0.05), and 4 vs. 16 cases, respectively ( < 0.05); the incidence of skin hematoma and ecchymosis was lower in the experimental group, i.e., 3 vs. 21 cases ( < 0.05).
Complete process management for horizontal rotational resection of a breast mass can shorten the duration of surgery, reduce the residual mass, postoperative bleeding, and postoperative malignancy rates, and improve the breast preservation rate and patient satisfaction. Accordingly, its popularization represents research value.
探讨乳腺肿块水平旋切术全程管理的临床效果。
回顾性研究2018年8月至2020年8月在中国医科大学附属人民医院甲状腺乳腺外科接受乳腺组织水平旋切术、超声乳腺影像报告和数据系统（BI-RADS）分类为4A及以下的638例患者。根据手术是否按照全程管理顺序进行，将这些患者分为实验组和对照组。两组的时间截点为2019年6月。采用倾向评分匹配法，根据年龄、肿块大小、位置、超声BI-RADS分类和乳房大小（以基底直径测量）进行1:1比例匹配，比较两组患者的手术时间（完成三步三维定位所需时间）、术后皮肤血肿和瘀斑、术后病理恶性率、肿块残留率及满意率。
匹配278对后，两组在人口统计学方面无统计学差异（P>0.05）。实验组手术时间明显短于对照组（分别为7.90±2.18分钟和10.20±5.99分钟；P<0.05）；实验组的满意度评分（8.33±1.36）高于对照组（6.48±1.22）（P<0.05）；实验组肿块的恶性率和残留率低于对照组，分别为6例和21例（P<0.05），以及4例和16例（P<0.05）；实验组皮肤血肿和瘀斑的发生率较低，分别为3例和21例（P<0.05）。
乳腺肿块水平旋切术的全程管理可缩短手术时间，降低肿块残留、术后出血及术后恶性率，提高保乳率和患者满意度。因此，其推广具有研究价值。
