超声引导下真空辅助旋切系统在乳腺纤维腺瘤治疗中的应用

The application of VACORA vacuum-assisted rotation system in the treatment of breast fibroadenoma under the guidance of ultrasound

目的探讨真空辅助旋切系统(VACORA旋切系统)在乳腺纤维腺瘤治疗中的应用价值。方法在超声实时监控下,利用真空辅助旋切系统对经超声检查诊断为乳腺纤维腺瘤的80例患者共106个乳腺病灶进行旋切治疗,术后对患者行超声随访,并将手术区超声图像与术前病灶图像进行对比分析,观察有无血肿及肿瘤残留。结果80例106个乳腺纤维腺瘤病灶均被准确定位及切除,经病理检查均诊断为纤维腺瘤。其中8例术中有血液沿引导针流出,经对针道加压止血后出血停止;9例术后1d复查可见手术区小血肿形成,术后3～6个月复查时,血肿完全消失;2例术后3个月后复查原纤维腺瘤病灶部位仍可见低回声灶,考虑为病灶残留。采用同一切口再次旋切治疗,旋切组织病理活检证实为纤维腺瘤伴肉芽组织形成;其余104个病灶手术部位均无残留病灶。所有患者术后皮肤切口无明显瘢痕。结论超声引导下利用真空辅助旋切系统可准确定位及切除乳腺纤维腺瘤,具有安全、微创、不影响乳房美观、并发症少等优点,值得进一步推广。

Objective To study the clinical value of VACORA vacuum-assisted rotation system in the treatment of fibroadenoma. Methods Under the screening of dynamic ultrasound, 106 beast lesions in 80 patients diagnosed as fibroadenoma by ultrasound were treated with VACORA vacuum-assisted rotation system, and all the patients were examined during follow-up visits. Results All the lesions were accurately positioned and resected, and demonstrated to be benign by pathologic examination. In 7 cases, bleeding was seen along the needle tract, which was stopped after compression. Small hematoma was seen in 9 patients in the second day of follow-up, which was disappeared in the 3 to 6 months of the follow-up. Three patients were demonstrated to have hypoechogenic area in the local area and were suspicious to be remnant lesions. All the incisions were not clear in the skin 3 to 6 months later after follow-up visits. Conclusions Fibroadenomas can be accurately positioned and resected with VACORA rotation system under the screening of ultrasound, which is safe, minimal invasive, prosthetic with rare complications.