内窥镜辅助清除聚丙烯酰胺水凝胶注射隆乳术后异物并一期假体置入

Removing breast foreign body resulted from augmentation with polyacrylamide hydrogel injection and silicone prosthesis implantation at one stage

目的 减少盲视下探查分离聚丙烯酰胺水凝胶注射隆乳术后形成的多发性异物囊腔造成的组织创伤,提高异物清除率和一期隆乳假体置入术效果.方法 2002年3月始采用腋窝部切口,在SEPS镜辅助下对分布于皮下、乳腺内、腺体后、胸肌内等不同解剖层次的异物团块囊腔探查剥离,清除聚丙烯酰胺水凝胶注入的异物后,再于胸大肌后剥离假体置入腔隙,经隧道置入乳房假体8例15侧.结果 术后无血肿、感染,伤口一期愈合,随访3～12个月,疼痛、乳腺团块结节和双侧乳房不对称畸形等术前不良临床表现消失,乳房挺拔,外形满意.结论 SEPS镜辅助直视下行注射隆乳异物取出较常规盲视下清创组织创伤小,更安全、确切、可靠,不失为注射隆乳异物清除的良好方法,一期假体置入,隆乳效果佳.

Objective This study was to investigate an operation, in which removing breast cysts of foreign body resulted from augmentation with polyacrylamide hydrogel injection was performed simultaneously with silicone prosthesis implantation under SEPS endoscope in order to relieve tissue injury and increase the accuracy of clearance. Methods Eight patients were included in this study. Preoperative type Bultrasound examination was performed to mark the mass. Through an axillary approach, the cysts of foreign body that were distributed in the subcutaneous tissue, breast or muscle were separated and ablated under SEPS endoscope. After removal of the foreign body, a silicone implant was located submuscularly for breast augmentation. Results The operations were completed without hematoma and infection. Follow-up of the eight patients for 3 to 12 months showed that preoperative symptoms relating to the injected material, such as breast pain, lump and asymmetry, have no longer existed. The shapes of the breasts were satisfactory. Conclusions We believe that endoscope-assisted mammoplasty offers more satisfactory clinical results with less injury, less morbidity, less scars, more accuracy and greater patient acceptance.