凝胶定位在乳腺导管内占位性病变微创切除中的应用研究

Excision of intraductal papilloma by Mammotome and fiberoptic ductoscopy after colloid locating

目的：探讨导管内精确定位后Mammotome联合纤维乳管镜（FDS）切除导管内乳头状瘤（IP）微创治疗方法的临床应用。方法：FDS寻找病灶，直视下注入显影剂利宁凝胶精确定位导管内病灶，B超引导下Mammotome切除IP31例，并与单纯Mammotome联合FDS切除IP12例及常规开放手术40例比较。结果：应用此方法成功切除31例IP患者的病灶（成功率100％），平均旋切组织3～5条，与单纯Mammotome联合FDS切除差异有统计学意义；病理学的检出率较后者提高近10％。而微创手术切除IP共43例，与常规40例比较手术并发症明显减少，住院时间明显缩短。结论：微创切除IP较常规手术术后并发症更少，病理检出率更高；利宁凝胶导管内精确定位、Mammotome联合FDS切除IP是更为安全和有效的微创手术方式。

OBJECTIVE： To introduce the method of excising the intraductal papilloma （IP） by Mammotome and fiberoptic ductoscopy（FDS） after intraductal locating. METHODS：IP was found out and the constrast medium was released under FDS, and the IPs of 31 patients were excised by mammotome system. This operational method was compared with the other methods of excising 12 IPs of patients by only Mammotome allying with FDS and of excising 40 IPs of patients by the routine operational method. RESULTS： The IPs of all 31 patients were succassfully excised by Mammotome allying with FDS after intraductal locating and the excision rate was 100 percent. The average numbers of excised organize of each IP were 3 to 5 strips and the pathologic detection rate was 100 percent and the average time of patients staying in hospital was 3 days. The results of this operational method was better than the other methods. CONCLUSIONS： The minimally invasive surgery method of excising the intraductal papilloma has less postoperative complications and the higher pathologic detection rate. The method of excising IP by Mammotome and FDS after intraductal locating is an effective minimally invasive surgery.