Vasseur C, Martinot V, Hodin E, Patenotre P, Pellerin P
Service de Chirurgie Plastique et Reconstructrice, Hôpital Salengro, Lille.
Ann Chir. 1998;52(2):146-57.
Gynecomastia is the commonest breast lesion in males. Fifty-two patients (mean age 24 years) operated in our department were reviewed with a mean follow-up of two years and a half. Gynecomastia occurred most frequently during puberty (63%), was bilateral (75%) and idiopathic (65%). The size of the enlargement was evaluated according to Simon's-classification based on breast-volume and skin-redundancy. 18 stage 1, 22 stage 2A, 9 stage 2B, 3 stage 3. Clinical examination and mammography determined the consistency of gynecomastia: adipose or firm. 4 different surgical managements were used: 32 subcutaneous mastectomies, 12 liposuctions, 6 liposuctions assocaited with subcutaneous mastectomy, 1 total mastectomy. One patient had liposuction on one side and subcutaneous mastectomy on the other one. All techniques gave good morphologic results. Nonetheless, the authors recommend the combination "liposuction and subcutaneous mastectomy", as this technique presents many advantages: small intraoperative blood loss, good skin redraping, short hospital stay, complete histologic examination of the material removed.
男性乳房肥大是男性最常见的乳房病变。对在我们科室接受手术的52例患者（平均年龄24岁）进行了回顾性研究，平均随访时间为两年半。男性乳房肥大最常发生在青春期（63%），双侧发病（75%）且病因不明（65%）。根据基于乳房体积和皮肤冗余度的西蒙分类法评估乳房增大的程度。18例为1期，22例为2A期，9例为2B期，3例为3期。通过临床检查和乳房X线摄影确定男性乳房肥大的质地：脂肪性或实性。采用了4种不同的手术治疗方法：32例皮下乳房切除术，12例抽脂术，6例抽脂术联合皮下乳房切除术，1例全乳房切除术。1例患者一侧行抽脂术，另一侧行皮下乳房切除术。所有技术均取得了良好的形态学效果。尽管如此，作者推荐“抽脂术和皮下乳房切除术”相结合的方法，因为该技术具有许多优点：术中出血量少、皮肤重新塑形效果好、住院时间短、切除组织可进行完整的组织学检查。
