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经腋下单孔内镜手术治疗乳腺良性肿瘤的临床效果。

Clinical effectiveness of transaxillary single-port endoscopic surgery in the treatment of breast benign tumor.

机构信息

Department of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

World J Surg. 2024 Sep;48(9):2064-2072. doi: 10.1002/wjs.12300. Epub 2024 Jul 30.

Abstract

BACKGROUND

Benign breast lumps affect 10% of women in their lifetimes. Endoscopic surgery could be an alternative surgical technique for benign breast tumors because it is performed through small wounds hidden in inconspicuous areas. The aim of this study was to explore the safety and esthetic effects of endoscopic surgery in the treatment of benign breast disease.

METHODS

This retrospective cohort study analyzed 363 patients with benign breast tumors from August 2021 to December 2023 in the Sixth Affiliated Hospital of Sun Yat-Sen University, of whom 118 underwent transaxillary single-port endoscopic surgery and 245 underwent traditional open surgery. Clinicopathologic characteristics, surgery type, hospital stay, and complications were analyzed to assess the effectiveness of the procedure for benign breast tumors.

RESULTS

Breast tumor resection was successfully performed in 363 patients by endoscopic surgery or traditional open surgery. Endoscopic procedures demonstrated longer durations of surgery (98.54 ± 35.17 min vs. 70.28 ± 26.06 min, p < 0.01) and postoperative drainage (64.30 ± 34.92 mL vs.18.49 ± 19.86 mL, p < 0.01), but there was less blood loss. The nipple-areolar complex of the patients who underwent endoscopic resection was significantly more sensitive than the traditional open surgery group. Patients in the endoscopic group reported higher satisfaction with surgical outcome (13.10 ± 1.97 vs. 12.63 ± 1.90, p < 0.01). And there was a significant difference in the wound scar and cosmetic outcome total score between the two groups.

CONCLUSION

Transaxillary single-port endoscopic surgery is effective and safe and improves postoperative nipple-areolar sensation and cosmetic outcome, as compared to the conventional technique.

摘要

背景

良性乳腺肿块影响女性一生的 10%。内镜手术可能是治疗良性乳腺肿瘤的一种替代手术技术,因为它是通过隐藏在不显眼区域的小伤口进行的。本研究旨在探讨内镜手术治疗良性乳腺疾病的安全性和美容效果。

方法

这是一项回顾性队列研究,分析了 2021 年 8 月至 2023 年 12 月中山大学附属第六医院收治的 363 例良性乳腺肿瘤患者,其中 118 例行经腋窝单孔内镜手术,245 例行传统开放手术。分析临床病理特征、手术类型、住院时间和并发症,以评估该手术方法治疗良性乳腺肿瘤的效果。

结果

363 例患者均成功通过内镜手术或传统开放手术切除乳腺肿瘤。内镜手术组的手术时间(98.54 ± 35.17 分钟比 70.28 ± 26.06 分钟,p < 0.01)和术后引流(64.30 ± 34.92 毫升比 18.49 ± 19.86 毫升,p < 0.01)时间较长,但出血量较少。接受内镜切除的患者乳头乳晕复合体的敏感性明显高于传统开放手术组。内镜组患者对手术结果的满意度更高(13.10 ± 1.97 比 12.63 ± 1.90,p < 0.01)。两组间的伤口疤痕和美容效果总分存在显著差异。

结论

与传统技术相比,经腋窝单孔内镜手术治疗良性乳腺肿瘤有效且安全,可改善术后乳头乳晕感觉和美容效果。

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