完全腔镜非溶脂法治疗男性乳房发育症(附20例报告)

Complete endoscopic subcutaneous mastectomy with non-fat clearing method for gynaecomastia: with a report of 20 cases

目的：探讨完全腔镜非溶脂法治疗男性乳房发育的应用价值及治疗效果。方法：分析2014年5月至2015年2月20例男性乳房发育患者行完全腔镜非溶脂法乳房皮下腺体切除术的临床资料。结果：手术均顺利完成,无中转开放手术。手术时间40-130 min,平均（70.2±10.5）min;术中出血量20-90 ml,平均（40.0±10.2）ml。术后切口瘢痕小、隐蔽,无术后出血、皮下积液、乳头坏死等并发症发生,术后住院4-10 d,平均（5.0±1.2）d。随访4-12个月,术后双乳形态自然、满意,无复发。结论：完全腔镜皮下乳腺切除术治疗男性乳房发育症美容效果好,创伤小,并发症少,安全性高,可作为治疗男性乳房发育症的首选微创术式。

Objective： To explore the application value and treatment effect of complete endoscopy with non-fat clearing method for gynaecomastia. Methods： Twenty patients with gynaecomastia from May 2014 to Feb. 2015 underwent complete endoscopic subcutaneous mastectomy with non-fat clearing method. Their clinical data and follow-up results were analyzed. Results： All operations were successfully completed,without conversion to open surgery. The mean operation time was（ 70. 2 ± 10. 5） min（ range,40-130 min）,and the intraoperative blood loss ranged from 20 to 90 ml,with an average of（ 40. 0 ± 10. 2） ml. After surgery,the scar was small and covert. Bleeding,subcutaneous hydrops,papilla necrosis or other complications did not occur after surgery. Postoperative hospital stay ranged from 4 to 10 d with an average of（ 5. 0 ± 1. 2） d. The follow-up was 4 to 12 months. After the operation,breasts morphology was satisfactory and natural,no recurrence was found. Conclusions： Complete endoscopic subcutaneous mastectomy for gynaecomastia is a preferred method of minimally invasive surgery with fine cosmetic effect,small trauma,few complications and high safety.