单切口腔镜辅助技术在乳腺纤维瘤手术中的应用

Single Incision of Video-assisted Technology in Breast Fibroidectomy

目的探讨单切口腔镜辅助技术在乳腺纤维瘤手术中应用的安全性和可行性。方法2011年10月～2013年5月，以腔镜辅助乳腺手术（video—assistedbreastsurgery，VABS）治疗20—40岁女性可触及乳腺纤维瘤12例，观察切口长度、病灶大小和距离切口长度对手术时间、出血量的影响，记录皮下淤血、瘀斑、皮下积液和皮肤灼伤等并发症的发生率及住院时间。结果12例均顺利完成手术，无中转常规手术病例。12例共切除病灶13枚，病灶大小1．0～3．9cm，（2．53±0．82）cm。切口长度2．0～3．0cm，（2．56±0．34）cm。切口距离病灶远端长度（距离）4．5～12．5cm，（8．14±2．55）cm。手术时间11～58min，（28．5±14．9）min，出血量0．5～70．0g，中位数5．0g。住院时间3～6d，（3．8±1．1）d。无术后并发症发生。手术时间与病灶大小和切口距离肿物远端的长度成正相关（R^2=0．785）。结论VABS是一种安全可靠的手术方式，达到了微创和美观的效果。其手术难度取决于病灶的大小和距离切口的长度。

Objective To explore the safety and feasibility of video-assisted technology in breast fibroidectomy. Methods From October 2011 to May 2013, video-assisted breast surgery （VABS） was used to remove the palpable breast fibroma in women aged between 20 to 40 years in 12 cases. The length of surgical incision, tumor size and the most distance from incision to tumor, operation time and blood loss were observed. Surgical complications such as subcutaneous ecchymosis, petechiae, subcutaneous hydrops, skin burns and patients＇ hospital day were recorded. Results All surgeries in 12 cases were successful, with no conversion to open surgery. Tumor size was 1. 0 - 3.9 cm, （2.53± 0.82） cm ; incision length was 2.0 - 3.0 cm, （2.56 ± 0.34） cm ; the most distance from incision to tumor was 4.5 - 12.5 cm, （8.14 ±2.55） cm; operation time was 11 -58 min, （28.5 ±14.9） min; median blood loss was 5.0 g （0.5 -70.0 g）; hospital day was 3 -6 d, （3.8±1. 1）d. Totally 13 tumors were removed. No postoperative complications occurred. The operation time had positive correlation with tumor size and the most distance from incision to tumor （R2 = 0. 785）. Conclusions VABS is safe and feasible. It achieves better cosmetic results with minimal damage. The operation time is related to tumor size and the most distance from incision to tumor.