微创旋切技术治疗多发乳腺小结节的临床研究

廖桦　方志红　陈龙林

【摘要】 目的：探讨微创旋切技术治疗多发乳腺小结节的应用效果。方法：选取2015年7月-2018年6月本院收治多发乳腺小结节患者250例，按不同外科手术方式分为微创手术（minimally invasive surgery，MIS）组和开放手术（conventional open excision，COE）组，每组125例。MIS组给予微创旋切技术治疗，COE组给予开放手术治疗。比较两组手术时间、术中出血量、拔管时间、切口愈合时间、乳房美容效果、术后6个月复发率及并发症发生率。结果：MIS组手术时间、术中出血量、拔管时间、切口愈合时间及术后6个月并发症发生率均明显低于COE组（P<0.05）。MIS组乳房美容效果优良率明显高于COE组（P<0.05）。两组术后6个月复发率比较，差异无统计学意义（字2=0.044，P>0.05）。结论：与开放手术相比，微创旋切技术治疗多发乳腺小结节具有明显优势。

【关键词】 微创旋切技术; 乳腺小结节; 多发性; 乳腺疾病

Clinical Study of Minimally Invasive Rotary Cutting Technique in the Treatment of Multiple Breast Small Nodules/LIAO Hua，FANG Zhihong，CHEN Longlin.//Medical Innovation of China，2019，16（18）：-114

【Abstract】 Objective：To explore the application effect of minimally invasive rotary cutting technique in the treatment of multiple breast small nodules.Method：250 patients with multiple breast small nodules admitted to our hospital from July 2015 to June 2018 were selected.They were divided into minimally invasive surgery（MIS）group and open surgery（COE）group according to different surgical methods，125 cases in each group.The MIS group was treated with minimally invasive rotary cutting technique，while the COE group was treated with open surgery.The operation time，intraoperative blood loss，extubation time，incision healing time，breast cosmetic effect，recurrence rate and complication rate 6 months after surgery of the two groups were compared.Result：The operation time，intraoperative blood loss，extubation time，incision healing time and the incidence of complications 6 months after surgery in the MIS group were significantly lower than those in the COE group（P<0.05）.The excellent rate of breast cosmetic effect in the MIS group was significantly higher than that in the COE group（P<0.05）.There was no significant difference in recurrence rate 6 months after surgery between the two groups（P>0.05）.Conclusion：Compared with open surgery，minimally invasive rotary cutting technique has obvious advantages in the treatment of multiple small breast nodules.

【Key words】 Minimally invasive rotary cutting technique; Breast small nodules; Multiple; Breast diseases

First-authors address：Dafeng Hospital of Chaoyang District，Shantou 515154，China

doi：10.3969/j.issn.1674-4985.2019.18.029

開放手术治疗多发乳腺小结节的手术入路主要有环乳晕切口、双环乳晕切口、弧形切口及放射状切口，此类手术入路的切口长度长及愈合后瘢痕明显，破坏了乳房表面皮肤的完整和外观[1-4]。同时，开放手术治疗多发乳腺小结节要通过上述手术入路构建皮下隧道来剔除病灶，在构建皮下隧道时不可避免对乳房的结构造成明显损伤，以至于手术后造成乳房毁形[5-6]。

随着人文环境的改变，女性对乳房保健和乳房美学的重视程度加深，人们对普外科治疗多发乳腺小结节的微创医学和美学效果提出了更高要求[7-10]。开放手术已经无法满足人们对微创医学和美学效果方面提出的新要求[11-14]。近期，本院采用微创旋切技术治疗多发乳腺小结节获得良好疗效，本着为微创旋切技术治疗多发乳腺小结节提供参考和依据的目的，将本研究患者的临床资料分析、总结。现报道如下。