乳腺导管瘘48例外科治疗分析

Surgical treatment for 48 cases of mammary duct fistula

目的探讨手术切除瘘管治疗乳腺导管瘘的效果。方法1998年1月～2005年12月，我院对39例乳腺导管瘘行瘘管切除联合周围部分腺体切除，4例行全乳切除，3例行皮下腺体切除，2例行乳头乳晕切除。33例一期缝合，15例敞开换药。结果48例随访3个月～8年，平均3年，一期缝合的33例中有5例复发，经敞开换药后治愈，余43例均一次性治愈。结论瘘管切除术是治疗乳腺导管瘘的基本手术原则，在减少复发的前提下，为保持乳房外形的美观及缩短住院时间，尽量予以一期缝合。

Objective To investigate the effect of surgical treatment of mammary duct fistula. Methods A total of 48 cases of mammary duct fistula were surgically treated, including 39 cases of fistulectomy and partial mastectomy, 4 cases of total mastectomy, 3 cases of subcutaneous mastectomy, and 2 cases of papillectomy. The incision was primarily sutured in 33 cases and kept open for drainage in 15 cases. Results A follow-up was carried out in the 48 cases for 3 months～8 years （mean, 3 years）. Out of the 33 cases of primary closure of wound, 5 cases developed a recurrence and then were cured by drainage and regular dressing change, The remaining 43 cases were cured on one session. Conclusions Fistulectomy is the basis of the treatment of mammary duct fistula. For a good cosmetic appearance and a short hospital stay, the operation should be performed with primary closure of wound, unless the recurrence is more likely to happen.