腔镜下行乳腺大纤维腺瘤切除术的临床效果

摘要

Objective To investigate the clinical effect of endoscopic resection for large breast fibroadenoma.Methods A total of 98 patients with unilateral diameter of 3-8 cm breast fibroadenoma were divided into endoscopic group(n=56) and open group(n=42).The endoscopic group received endoscopic resection via posterior axillary line in lateral position or via subcostal approach in horizontal position,while the open group received open surgery.The operation duration,postoperative analgesic drug use,postoperative complications,postoperative hospital stay,total hospitalization cost and subjective cosmetic effect score were compared between the two groups.The postoperative recurrence of the patients was followed up.Results The operations in both groups were successfully completed.After 12 months of follow-up,35 cases were lost to follow up,and no local recurrence occurred in the other 63 cases.The operation duration,hospitalization cost and subjective cosmetic effect score of the endoscopic group were more or higher than those of the open group,but the proportion of postoperative analgesic drugs use in the endoscopic group was less than that in the control group(P<0.05).There was no significant difference in the postoperative complications or postoperative hospital stay between the two groups(P>0.05).Conclusion Endoscopic resection for large breast fibroadenoma is a safe and feasible method with advantages of cosmetic effect and mild pain,but it has some disadvantages,such as high hospitalization cost and long operation duration.%目的 探讨腔镜下行乳腺大纤维腺瘤切除术的临床效果.方法 将单侧直径3~8 cm的乳腺纤维腺瘤患者98例分为腔镜组56例及开放组42例,腔镜组经侧卧位腋后线或平卧位肋缘下入路行腔镜下切除术,开放组采用开放式手术.比较两组的手术时间、术后镇痛药物应用情况、术后并发症、术后住院时间、总住院费用及主观美容效果评分,随访患者术后复发情况.结果 两组均顺利完成手术.随访12个月期间有35例失访,其余63例均未发现局部复发.腔镜组手术时间、住院费用、主观美容效果评分均高于或长于开放组,而术后镇痛药物应用比例少于对照组(P<0.05).两组术后并发症及术后住院日比较,差异无统计学意义(P>0.05).结论 腔镜下乳腺大纤维腺瘤切除术是一种安全、可行的方法,具有美容和疼痛轻的优点,但存在住院费用高、手术时间长等缺点.