实时三维超声引导VACORA真空微创穿刺活检系统在乳腺良性疾病微创诊疗中的应用

Real-time three-dimensional ultrasonography-guided VACORA vacuum-assisted rotation system in treatment of benign breast diseases

目的探讨三维超声引导下VACORA真空微创穿刺活检系统在乳腺良性疾病诊疗中的应用价值。方法选取术前诊断为乳腺良性肿块患者103例(223个肿块),经二维超声引导治疗54例(二维组),经实时三维超声引导治疗49例(三维组),记录两组患者肿块容积、手术切除条数、手术耗时、术后血肿发生情况及血肿吸收情况。结果全部肿块均成功引导切除,两组患者手术耗时无明显差异(P>0.05),三维组肿块切除条数及术后血肿发生率均明显少于二维组(均P<0.05),而且血肿0.16~3.80ml者平均吸收时间均显著明显短于血肿4.7~19.5及25.2~32.0ml者(均P<0.01)。两组患者术后随访1~12个月均无复发。结论超声引导VACORA真空微创穿刺活检系统适用于体积<2.4ml乳腺良性肿块的微创切除,实时三维超声引导定位准确、安全、损伤小,是乳腺肿块微创切除的一种有效方法 。

Objective To evaluate the application of VACORA vacuum-assisted rotation system guided by three-dimen- sional ultrasonography in treatment of benign breast diseases. Methods One hundred and three patients with benign mass were randomly assigned to receive two-dimensional ultrasonography-guided （2-D group, n=54） or real-time three-dimensional ultrasonography- guided （3-D group, n=49） VACORA vacuum-assisted rotation system treatment. The volume of mass, excised number, operation time, number and volume of hematoma, the time of hematoma absorption were compared between two groups. Results All the masses were excised successfully. There was no significant difference in operation time between two groups（P 〉0.05）; the excised number and incidence of postoperative hematoma in 3-D group were less that those in 2-D group （P〈0.05）. The absorption time of hematoma 0.16 - 3.80ml was significant less than that of hematoma 4.7 - 19.5 and 25.2 - 32.0ml （both P〈0.01）. No recurrence was found in both groups during the follow-up for 1-12 months. Conclusion Real-time three-di- mensional ultrasonography-guided VAC^RA vacuum-assisted rotation system is effective in minimally invasive excision of be- nign breast mass with the advantage of accurate location, safety and less damage.