【摘要】 目的:彩超引导下侧切和(或)背切在乳腺良性病灶Mammotome微创旋切术中的临床应用价值。材料与方法:均采用Mammotome微创旋切系统对病灶进行切除对微创手术的121例患者(121个良性病灶)随机使用侧切和(或)背切正向切联合(实验组,n=59)和单纯正向切(对照组,n=62),观察3个亚组(病灶最大直径D<1.0cm、1.0 cm≤D<2.0 cm、D≥2.0cm)的术中平均对位时间、平均旋切时间、完全切除率及并发症,并进行统计学分析。结果:(1)最大直径(D)<1.0cm的病灶,实验组平均对位时间(39.35±7.88s)少于对照组(42.95±7.01s),差异无统计学意义(t=1.619,P>0.05);实验组平均切割时间(4.48±1.56min)多于对照组(4.068±1.256min),差异无统计学意义(t=0.967,P> 0.05);(2)1.0cm≤D <2.0cm病灶,实验组平均对位时间(40.71±5.98s)少于对照组(50.83±7.02s),差异有统计学意义(t=5.166,P<0.05),实验组平均切割时间(6.79±1.19min)少于对照组(7.78±1.83min),差异有统计学意义(t=2.124,P<0.05);(3)D≥2.0cm病灶,实验组平均对位时间(46.67±6.99s)少于对照组(63.44±10.76s),差异有统计学意义(t=5.109,P<0.05),实验组平均切割时间(18.52±4.612min)少于对照组(22.20±4.618min),差异有统计学意义(t=2.219,P<0.05);实验组的病灶完全切除率(58/59,98.31%)与对照组(61/62,98.38%)比较,差异无统计学意义(X~2<0.01,P>0.05)。术后并发症主要包括局部血肿、局部皮下淤斑、局部皮肤1破损,实验组发生率(7/59,11.86%)与对照组(8/62,12.90%)比较,差异无统计学意义(X~2=0.02,P>0.05)。结论:超声引导下的侧切和(或)背切在D≥1.0cm乳腺良性肿块微创切除中较单纯正位切割中能明显缩短平均对位时间和旋切时间。更多还原

【Abstract】 Objective:To investigate the clinical value of using ultrasound-guided lateral and/or dorsal Mammotome minimally invasive resection of breast benign leisions.Methods:Mammotome minimally invasive peeling system was used to remove all of the breast benign lesions. 121 patients(121 benign lesions) were randomized into two groups. Group A(Experimental Group, n=59): using lateral and/or dorsal resection combined with forward excision; Group B(Control Group, n=62) : using simple forward resection. The mean time of contraposition and rotational resection, complete resection rate and postoperation complication were observed and compared in three subgroups(maximal diameter(D) <1.0 cm, 1.0 cm≤D <2.0 cm, D≥2.0 cm) using statisctial analysis.Results:(1)In the subgroup of maximal lesion diameter(D<1.0 cm),the mean time of contrapostion in Group A(39.35±7.88 s) was less than that in Group B(42.95±7.01 s), with no statistically significant difference(t=1.619,P>0.05). The mean time of rotational resection in Group A(4.48±1.56 min) was more than that in Group B(4.068±1.256 min),with no statistically significant difference(t=0.967,P>0.05);(2) In the subgroup of maximal leision diameter(1.0 cm≤D<2.0 cm), the mean time of contrapostion in Group A(40.71±5.98 s) was less than that in Group B(50.83±7.02 s), with statistically significant difference(t=5.166,P<0.05). The mean time of rotational resection in Group A(6.79±1.19 min) was less than that in Group B(7.78±1.83 min),with statistically significant difference(t=2.124,P<0.05);(3) In the subgroup of maximal leision diameter(D≥2.0 cm), the mean time of contrapostion in Group A(46.67±6.99 s) was less than that in Group B(63.44±10.76 s), with statistically significant difference(t=5.109,P<0.05). The mean time of rotational resection in Group A(18.52±4.612 min)was less than that in Group B(22.20±4.618 min),with statistically significant difference(t=2.219,P<0.05);The complete resection rate was(58/59,98.31%)in Group A and(61/62,98.38%)in Group B with no statistically significant difference(X~2<0.01,P>0.05). The postoperation complication including local hematoma,subcutaneous ecchymosis and skin damage.The incidence of complication was(7/59,11.86%)in Group A and(8/62,12.90%)in Group B with no statistically significant difference(X~2=0.02,P>0.05).Conclusion:Using Ultrasound-guided lateral and/or dorsal resection can significantly shorten the average contrapostion and resection time than using simple forward resection during breast minimally invasive surgery, when the breast benign leision diameter≥1.0 cm.更多还原