内窥镜辅助下腋窝入路隆乳术的临床体会

Clinical experience of using endoscope-assisted armpit access augmentation mammaplasty

目的:为了减少在常规隆乳术中由于分离时存在视觉误区而对组织造成损伤,进而引起术中出血症状,探究在内镜辅助下腋窝入路隆乳术的临床可能性及优势。方法:选择2009年1月～2011年1月来我院就医者52例,所有病例均进行双侧腋窝入路隆乳,观察患者术中出血情况以及隆乳效果分析。结果:52例患者中,38例患者48h内两侧引流量小于20ml,13例患者48h两侧引流量小于30ml,只有1例患者48h两侧引流量大于30ml,在进行完引流后术后的5天内拔管。术后常规抗生素应用3日后无感染、出血等并发症出现。乳房形态优美自然,活动度良好,出现包膜挛缩11例,6例患者出现术后乳头乳晕感觉异常,术后1月后均恢复正常。结论:内窥镜辅助下腋窝入路隆乳手术,创伤小、并发症少、恢复快、效果好。但也有许多的局限性,如乳房下皱襞较薄弱的患者,如何在内窥镜下进行脱细胞真皮片加强,如何解决在腋下切口进行腔内缝合固定的问题等等,还需进一步的研究与探讨。

Objective To explore the clinical possibility and advantage of using endoscopy assisted the armpit access augmentation mammaplasty. In order to reduce error,because of the separation visual error, so as to cause damage to the organization, and then cause intraoperative bleeding symptoms. Methods Choose from January 2009 to January to our doctor is 52 cases, all cases were in double side armpit into the path of the patients were observed to have breastimplants, intraoperatie bleeding breast augmentation and effect analysis. Results In 52 patients, and patients and h on both sides in less than twenty ml lead flow, 13 patients and h on both sides of the lead flow less than 30 ml, only 1 patients and h on both sides of the lead flow more than 30 ml, patients in the drainage after five days after drawing tube. The conventional antibiotic application in 3 without infection, bleeding complications. Breast shape beautiful nature, good activity, appear capsular contracture in 11 cases,6 cases （the nipple areola paresthesia, postoperative after a month are back to normal. Conclusions Using endoscope-assisted armpit access breast augmentation surgery, small trauma, fewer complications, rapid recovery, and the effect is good. But endoscopic prosthesis breast augmentation technology although there are a lot of advantages, there are still many limitations, such as breast plica under weak patient, how to take off the cells under endoscope leather piece of strengthening, how to solve the under arm incision for intracavity suture fixed problems and so on, but also we need to further research and discussion.