乳腺微创旋切术在乳腺良性微小病灶中的临床应用

摘要

目的：探讨 Encor 微创旋切术在乳腺良性小病灶切除术中的应用价值。方法：2013年1月－2014年6月，379例女性患者，在彩超实时引导下，应用 Encor 微创旋切系统，完整切除801个乳腺微小病灶，术后病理示：796个为良性病灶，5个为乳腺癌。结果：379例患者均顺利完成了手术，术中疼痛可忍，VAS 评分均在3分以下；在≤3个肿块的157例患者中，术中出血、术后血肿、皮下瘀斑发生率分别为4．46％、8．92％和17．20％；在＞3个肿块的222例患者中，术中出血、术后血肿、皮下瘀斑发生率分别为10．36％、17．12％和21．17％，差别有统计学意义（P ＜0．05），所有血肿、皮下瘀斑随访3个月均自行吸收消失。术中所有患者无皮肤误切，术后均无感染发生、乳房变形和明显瘢痕形成，患者满意，术后3个月复查彩超，无1例肿物残留。结论：彩超引导下乳腺微小肿块 Encor 微创旋切术，具有定位准确、切除完整、出血少、瘢痕小、乳房无变形等优点，患者满意度高。%Objective:To investigate the value of ultrasound -guided Encor system in minimally invasive surgery for breast benign tiny lesion resection.Methods:From January 2013 to June 2014,801 breast tiny lesions of 379 pa-tients were excised by of high -frequency color Doppler ultrasound guided Real -time monitoring Encor vacuum as-sisted minimally invasive cutting system in minimally invasive surgery.Postoperative pathology:796 cases were benign lesions,5 cases were breast cancer.Results:All of the breast tiny lesions were complete resected of 379 patients.Intr-aoperative an pain can be managed,VAS score below 3 points.In ≤3 lesions of 157 patients,the incidence of intraop-erative bleeding,postoperative hematoma,subcutaneous ecchymosis were 4.46%,8.92% and 17.20% respectively. In >3 lesions of 222 patients,the incidence of intraoperative bleeding,postoperative hematoma,subcutaneous ecchy-mosis were 10.36%,17.12% and 21.17%,respectively(P <0.05).All the postoperative hematoma,subcutaneous ecchymosis were absorbed disappear followed up 3 months.Intraoperative no case can be shin cut,there were no post-operative infection,breast deformation and obvious scar.Patients felt very satisfied.All patients were followed -up by high -frequency color Doppler ultrasound after 3 months,there was no case of the mass residuce.Conclusion:High -frequency ultrasound -guided Encor system in minimally invasive surgery has many superiorities such as accurate lo-cating,high complete resection rate,less intraoperative bleeding,smaller scars,breast no deformation,higher satis-fied,etc.It can be used as preferred surgical approach for the benign breast tiny lesions excision.