微创旋切术和开放局部切除术治疗乳腺良性叶状肿瘤的疗效比较

Comparison of minimally invasive and open local resection for benign phyllodes tumors of breast

目的比较微创旋切术与开放性局部肿块切除术治疗乳腺良性叶状肿瘤的临床疗效。方法选取2009年5月至2017年1月在广东省中西医结合医院接受治疗的72例乳腺良性叶状肿瘤患者进行回顾性研究,按手术方式不同,分为微创组34例,局切组38例。分别以手术时间、术中出血量、愈合时间、瘢痕长度、术后血肿、瘀斑、迟发性出血、伤口愈合不良、肿瘤复发、患者满意度评价指标对两组进行比较分析。结果微创组患者手术时间、术中出血量、愈合时间、瘢痕长度均优于局切组(P<0.05)。微创组患者较局切组更易出现术后瘀斑,差异有统计学意义(P<0.05)。在术后血肿、迟发性出血、伤口愈合不良上两组比较,差异无统计学意义(P>0.05)。微创组肿瘤复发率为11.8%,局切组为13.2%,两者比较差异无统计学意义(P>0.05)。微创组患者总体满意度高于局切组(P<0.05),在治疗满意度和外观满意度上微创组均高于局切组(P<0.05)。结论微创旋切术对比开放性局部切除术治疗乳腺良性叶状肿瘤具有创伤小、恢复快、美容效果好的优点。

Objective Comparing the clinical efficacy between minimally invasive rotational resection and open local resection in the treatment of benign phyllodes tumors of breast. Methods A total of 37 cases of benign phyllodes tumors of breast who had been treated in our hospital from May 2009 to Janurary 2017 were retrospectively analyzed,according to the different methods of operation,divided into minimally invasive group of19 cases,local resection group of 18 cases,make comparative analysis between the two groups with respectively evaluating indicators of operative time,blood loss,healing time,scar length,postoperative hematoma,ecchymosis,delayed bleeding,wound healing,tumor recurrence and patient satisfaction. Results The indicators of operative time,blood loss,healing time,and scar length in minimally invasive group were better than those in local resection group（P〈0. 05）. The patients in minimally invasive group were more prone to postoperative ecchymosis than those in local resection group,the difference was statistically significant（P〈0. 05）,There was no significant difference between the two groups in postoperative hematoma,ecchymosis,delayed bleeding and wound healing（P〉0. 05）. The rate of tumor recurrence in minimally invasive group was 11. 8%,and 13. 2%in local resection group,the difference was not statistically significant（P〉0. 05）. The satisfaction in minimally invasive group was higher than that in local resection group（P〈0. 05）. The differences of appearance satisfaction and treatment satisfaction were statistically significant（P〈0. 05）. Conclusion Compared with the open local resection,minimally invasive rotational resection is more effective for the treatment of benign phyllodes tumors with less trauma,faster recovery and better cosmetic effect.