Wang Qinbo, Yang Qingyu, Li Zongyan, Fu Xiaoyan, Guo Yonghai, Chen Zuxiao, Li Haiyan
Division of Breast Surgery, Department of General Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Pharmacy, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Gland Surg. 2024 Jul 30;13(7):1269-1280. doi: 10.21037/gs-24-139. Epub 2024 Jul 24.
Endoscopic curative excision of benign breast diseases (BBDs) can preserve the cosmetic appearance of the breast. However, endoscopic surgery is not feasible, and some challenges still need to be addressed. Traditional line marker localization methods cannot visualize tumors, and the exploration of deep tumors may lead to certain risks of accidental injury. This study aimed to investigate the value of the methylene blue location (MBL) technique in endoscopic resection of deep-seated benign breast tumors.
A total of 217 patients with benign deep breast tumors admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between November 2017 and June 2023 met the inclusion criteria. Among them, 107 patients underwent endoscopic resection with a MBL, in which methylene blue was injected to guide the tumor resection endoscopically, whereas 110 patients underwent endoscopic resection with a skin mark location (SML), in which the tumor was located by a marking line on the skin. We compared patient characteristics, surgery-related data, complications, and cosmetic outcomes between the two groups.
Endoscopic breast tumor resection was successfully performed in 217 patients, none of whom had undergone open surgery. The mean operation time was significantly different between the MBL and SML groups (45.70±12.508 and 49.59±10.997 min, respectively; P=0.008<0.05), and blood loss in the MBL group was significantly reduced compared with that in the SML group (11.07±5.665 and 13.83±7.918 mL, respectively; P=0.004<0.05). There were no significant differences in drainage volume, length of hospital stay, or postoperative complications between the MBL and SML groups (P>0.05). The postoperative cosmetic outcomes of the patients were noteworthy, with no statistically significant differences between the two groups.
The methylene blue positioning technique is safe and effective for the endoscopic treatment of deep breast tumors. It shortens operation time, reduces surgical complications, and is worthy of clinical promotion.
内镜下根治性切除良性乳腺疾病(BBD)可保留乳房的美观。然而,内镜手术不可行,仍有一些挑战需要解决。传统的线标记定位方法无法可视化肿瘤,对深部肿瘤的探查可能导致一定的意外伤害风险。本研究旨在探讨亚甲蓝定位(MBL)技术在内镜下切除深部良性乳腺肿瘤中的价值。
2017年11月至2023年6月期间,中山大学附属第六医院收治的217例深部良性乳腺肿瘤患者符合纳入标准。其中,107例患者采用MBL进行内镜切除,术中注射亚甲蓝以在内镜下引导肿瘤切除;110例患者采用皮肤标记定位(SML)进行内镜切除,通过皮肤上的标记线定位肿瘤。我们比较了两组患者的特征、手术相关数据、并发症及美容效果。
217例患者均成功进行了内镜下乳腺肿瘤切除,均未接受开放手术。MBL组和SML组的平均手术时间有显著差异(分别为45.70±12.508和49.59±10.997分钟;P = 0.008<0.05),MBL组的失血量较SML组显著减少(分别为11.07±5.665和13.83±7.918毫升;P = 0.004<0.05)。MBL组和SML组在引流量、住院时间或术后并发症方面无显著差异(P>0.05)。患者的术后美容效果值得关注,两组之间无统计学显著差异。
亚甲蓝定位技术在内镜治疗深部乳腺肿瘤中安全有效。它缩短了手术时间,减少了手术并发症,值得临床推广。