三种真空辅助微创旋切技术治疗乳腺良性病灶的疗效及并发症比较

摘要

目的比较Vacora,Mammotome和EnCor3种真空辅助旋切系统对乳腺良性病灶的治疗疗效、治疗时间及并发症中的差异.方法 2005年3月到2009年5月,对983个乳腺良性病灶分别采用Vacora,Mammotome和EnCor3种真空辅助旋切设备进行了微创旋切治疗,记录并比较3种设备的完全切除率、治疗时间和并发症(血肿、疼痛、瘀斑).结果 微创旋切治疗后,99.7%(980/983)的病灶病理证实为良性.完全切除率为94.8%(932/983).在最大直径≥1.5 cm的病灶中,EnCor和Mammotome组的完全切除率分别为97.0%(229/236)和96.9%(95/98),均显著高于Vacora组(82.2%,134/163),差异有统计学意义(χ2=24.040、11.013,P<0.05).EnCor组的治疗时间为(6.6±6.5)min,显著少于Mammotome组(10.6±9.3)min 和Vacora组(25.6±23.3)min,差异有统计学意义(t=3.565、12.601,P均<0.05).EnCor组(52/356)和Mammotome组(20/143)血肿发生几率显著高于Vacora组(25/484)(χ2=20.841、12.892,P均 <0.05).结论 3种真空辅助旋切系统治疗乳腺良性病变均可取得非常满意的疗效.EnCor系统和Mammotome系统完全切除率高,手术时间短,但出现血肿的几率较高.Vacora系统完全切除率相对较低,手术时间较长,但出现血肿的几率较低.%Objective To compare three devices ( Vacora, Mammotome(R) And EnCor(R) ) in percutaneous excisional biopsy of clinically-benign breast lesions in terms of complete excision rate, duration of procedure and complications. Methods In a retrospective study between March 2005 and May 2009,983 lesions underwent ultrasound-guided excisional biopsy with three vacuum-assisted systems respectively. The completely excision rate, duration of procedure and complications( hematoma, pain and ecchymosis )were recorded and compared. Results 99. 7%( 980/983 )lesions were demonstrated to be benign by pathology after percutaneous excisional biopsy. The overall complete excision rate was 94. 8% ( 932/983 ). In lesions whose largest diameter equal to or larger than 1. 5 cm,the complete excision rates of EnCor(R)group( 97. 0% , 229/236 )and Mammotome(R) Group( 96. 9% ,95/98 )were significantly higher than that of Vacora (R) Group ( 82. 2% ,134/163)(x2 =24.040,11.013,all P <0. 05 ). The EnCor(R) Group( 6. 6 ±6. 5 rain )had a significantly shorter duration of procedure than Mammotome (R)( 10. 6 ± 9. 3 min )and Vacora(R) Group( 25. 6 ± 23. 3 min ) ( t =3. 565,12. 601 ,all P <0.05 ). Hematoma occurred more frequently in EnCor(R) Group and Mammotome(R) Group than that in Vacora(R) Group( x2 = 20. 841 > 12- 892, all P < 0. 05 ). Conclusions All these three vacuum-assisted systems are highly effective for excisional biopsy of benign breast lesions. EnCor(R) And Mammotome systems have significantly higher complete excision rates and shorter durations of procedure than Vacora(R) System. But the incidence of hematoma is lower in Vacora(R) Group