乳腺微创旋切术在乳腺良性微小病灶中的临床应用

Application of utrasound-guided Encor system in minimally invasive surgery for breast benign tiny lesion resection

目的:探讨Encor微创旋切术在乳腺良性小病灶切除术中的应用价值。方法:2013年1月-2014年6月,379例女性患者,在彩超实时引导下,应用Encor微创旋切系统,完整切除801个乳腺微小病灶,术后病理示:796个为良性病灶,5个为乳腺癌。结果:379例患者均顺利完成了手术,术中疼痛可忍,VAS评分均在3分以下;在≤3个肿块的157例患者中,术中出血、术后血肿、皮下瘀斑发生率分别为4.46%、8.92%和17.20%;在>3个肿块的222例患者中,术中出血、术后血肿、皮下瘀斑发生率分别为10.36%、17.12%和21.17%,差别有统计学意义(P<0.05),所有血肿、皮下瘀斑随访3个月均自行吸收消失。术中所有患者无皮肤误切,术后均无感染发生、乳房变形和明显瘢痕形成,患者满意,术后3个月复查彩超,无1例肿物残留。结论:彩超引导下乳腺微小肿块Encor微创旋切术,具有定位准确、切除完整、出血少、瘢痕小、乳房无变形等优点,患者满意度高。

Objective：To investigate the value of ultrasound -guided Encor system in minimally invasive surgery for breast benign tiny lesion resection. Methods：From January 2013 to June 2014,801 breast tiny lesions of 379 pa- tients were excised by of high - frequency color Doppler ultrasound guided Real - time monitoring Encor vacuum as- sisted minimally invasive cutting system in minimally invasive surgery. Postoperative pathology ：796 cases were benign lesions,5 cases were breast cancer. Results：All of the breast tiny lesions were complete resected of 379 patients. Intr- aoperative an pain can be managed,VAS score below 3 points. In ≤3 lesions of 157 patients ,the incidence of intraop- erative bleeding, postoperative hematoma, subcutaneous ecchymosis were 4.46% , 8.92% and 17.20% respectively. In 〉 3 lesions of 222 patients, the incidence of intraoperative bleeding, postoperative hematoma, subcutaneous ecchy- mosis were 10.36% , 17.12% and 21.17% , respectively（P 〈 0.05 ）. All the postoperative hematoma, subcutaneous ecchymosis were absorbed disappear followed up 3 months. Intraoperative no case can be shin cut, there were no post- operative infection, breast deformation and obvious scar. Patients felt very satisfied. All patients were followed - up by high - frequency color Doppler ultrasound after 3 months, there was no case of the mass residuce. Conclusion： High - frequency ultrasound - guided Encor system in minimally invasive surgery has many superiorities such as accurate lo- cating, high complete resection rate, less intraoperative bleeding, smaller scars, breast no deformation, higher satis- fied, etc. It can be used as preferred surgical approach for the benign breast tiny lesions excision.