腔镜下溶脂吸脂术与传统开放式切除术治疗男性乳房发育症疗效对比

Efficacy Comparison of Endoscopic Liposuction and Traditional Surgery in the Treatment of Gynecomastia

目的:比较腔镜下溶脂吸脂术与传统开放式切除术治疗男性乳房发育症的疗效。方法:回顾性分析2018年2月-2021年12月笔者医院收治的74例男性乳房发育症(Gynecomasti,GYN)患者的临床资料,根据手术方式不同分为对照组(n=38)和观察组(n=36),对照组采用传统开放式切除术治疗,观察组采用腔镜下溶脂吸脂术治疗,比较两组围术期指标(切口长度、手术时间、术中出血量、住院时间及拆线时间)、疼痛程度[视觉模拟评分法(Visual analogue scale,VAS)评分]、瘢痕情况[温哥华瘢痕评估量表(Vancouver scar scale,VSS)评分]、并发症发生率、术后美观度、心理状态[抑郁自评量表(Self-rating depression scale,SDS)和焦虑自评量表(Self-rating anxiety scale,SAS)]及满意度。结果:观察组切口长度、手术时间、住院时间及拆线时间均短于对照组,术中出血量少于对照组(P<0.05);观察组并发症发生率低于对照组(2.78%vs 18.42%)(P<0.05);术后3 h,观察组VAS评分低于对照组(P<0.05);术后6个月,观察组VSS评分及SDS、SAS评分低于对照组(P<0.05);观察组乳房美观度优于对照组(100.0%vs 78.95%)(P<0.05);观察组患者乳房双侧对称性满意度、术区皮肤及乳头感觉满意度及患者整体自我满意度评分均高于对照组(P<0.05)。结论:与传统开放式切除术比较,腔镜下溶脂吸脂术切口小、出血量少、疼痛轻、术后恢复快、乳房美观度较好,可促进GYN患者预后,提高患者满意度,并改善患者不良情绪,值得临床推广。

Objective To compare the efficacy of endoscopic liposuction and traditional open resection in the treatment of gynecomastia.Methods The clinical data of 74 patients with gynecomastia(GYN)admitted to the author's hospital from February 2018 to December 2021 were retrospectively analyzed.According to different surgical methods,the patients were divided into control group(n=38)and observation group(n=36).The control group was treated with traditional open resection,and the observation group was treated with endoscopic liposuction.perioperative indexes(length of incision,operation time,intraoperative blood loss,length of hospital stay,suture removal time),the visual analogue scale(VAS)scores,the vancouver scar scale(VSS)scores,the incidence of complications,postoperative aesthetic degree,Psychological status[self-rating anxiety scale(SAS),self-rating depression scale(SDS)]and satisfaction were compared between the two groups.Results The length of incision,operation time,length of hospital stay and suture removal time in the observation group were shorter than those in the control group,and intraoperative blood loss was less than that of the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(2.78%vs 18.42%)(P<0.05).The VAS scores,SDS and SAS scores of the observation group were lower than those of the control group at 3 h and 6 months after surgery(P<0.05).The aesthetic degree in the observation group was higher than that in the control group(100.0%vs 78.95%)(P<0.05).The satisfaction scores for bilateral symmetry,skin and nipple sensation in the surgical area,and overall self-satisfaction score of the observation group were higher than those of the control group(P<0.05).Conclusion Compared with traditional open resection,endoscopic liposuction has smaller incision,less blood loss,less pain,faster postoperative recovery,and better breast aesthetics,which can promote the prognosis of GYN patients,improve patient satisfaction,and improve patients'adverse emotions,and is worthy of clinical promotion.