超声引导下Mammotome系统切除良性乳腺肿块临床应用体会

Application experience of ultrasound guided Mammotome minimally invasion surgery in benign breast lesion

目的探讨超声引导下麦默通（Mammotome）微创旋切系统对良性乳腺肿块进行微创切除的应用价值。方法回顾性分析2013年7月至2014年8月宿迁市人民医院98例患者共245枚良性乳腺肿块在超声引导下行Mammotome微创旋切术的临床资料，术后6个月复查随访，评价Mammotome微创旋切术在良性乳腺肿块切除中的应用价值。结果所有肿块均成功在超声引导下进行旋切，每枚肿块平均手术切除时间（15±9．3）min，平均旋切（12±5．6）次；肿块经术后病理学诊断均为良性，其中纤维腺瘤183例，乳腺腺病38例，乳腺腺病伴不典型增生4例，导管内乳头状瘤3例，乳腺囊肿17例；主要手术并发症为：局部皮肤瘀斑35例，术后血肿12例，术中出血7例，术后感染1例。患者均获临床和超声随访6个月，所有患者均未见肿块残留、复发，瘢痕小而隐蔽。结论超声引导下Mammotome微创旋切技术切除良性乳腺肿块，定位直观、准确，操作简单、方便，患者痛苦小、愈合快，美容效果满意，可在临床推广应用。

Objective To study the value of ultrasound guided Mammotome minimally invasion surgery in benign breast lesion. Methods The clinical data of 98 eases with 245 breast lesions umterwent ultrasound guided Mammotome minimally invasion surgery were retrospective analysied.The application value of Mammotome system were evaluated 6 months followed-up after operation. Results All the breast lesions were excised safely and completely by Mammotome system.The average operation time of every lesion was（15 ±9.3）min and the average number of times of resection was（12 ±5.6） times.Postoperative pathological examination showed all the lesions were benign.There were fibroadenoma in 183 lesions,breast adenosis in 38,breast adenosis with dysplasia in 4,intraductal papilloma in 3 and breast cyst in 17.The main operation complications after operation were 7 cases of intraoperative hemorrhage,12 cases of hematoma,35 cases of ecchymosis and 1 case of infection.All the patients were followed up for 6 months by physical and ultrasound examination.There were no operative residual or recurrent lesions were found and the scar is little and cryptic. Conclusions The technique of ultrasound guided Mammotome minimally invasion surgery in benign breast lesion has some advantages such as precise and direct positioning, easy operation, small pain, fast healing and satisfactory cosmetic effect.It is worthy of clinical application widely.