腋窝入路单孔腔镜法治疗男性乳房发育症的临床报告

A clinical study of single-hole axillary endoscopic mastectomy for gynecomastia

目的评价腋窝入路单孔腔镜法与传统乳腺切口皮下腺体开放切除术治疗男性乳房发育症的临床疗效。方法回顾性分析2020年4月至2021年5月手术治疗的Ⅱ~Ⅲ级男性乳腺发育的33例患者的临床资料,其中腋窝入路单孔腔镜手术组15例,传统手术组18例。比较两组患者的手术情况及术后恢复情况。结果腋窝入路单孔腔镜手术组手术操作中位时间88.67min,放置引流管中位时间4.40d,住院中位时间7.67d。传统手术组手术操作中位时间58.06min,放置引流管中位时间1.94d,住院中位时间4.89d,两组比较无显著差异(P>0.05)。两组均未出现感染;腋窝入路单孔腔镜手术组有1例术后血肿,传统手术组出现2例乳头部分坏死,两组患者术后血肿发生率、乳头部分坏死发生率无显著差异(P均>0.05)。腋窝入路单孔腔镜手术组13例患者对手术后外观评为非常满意,传统手术组5例非常满意,腋窝入路单孔腔镜手术组术后满意度显著高于传统手术组(P=0.001)。结论腋窝入路单孔腔镜手术治疗男性乳腺发育症,相较传统手术,切口更加隐蔽,美容效果好,满意度更高。

Objective To compare the clinical efficacy of single-hole axillary endoscopic mastectomy and traditional open incision in the treatment of gynecomastia.Method 33 patients with gynecomastia gradeⅡ~Ⅲ(including 15 cases in an experimental group and 18 in a control group)from April 2020 to May 2021 were enrolled in the retrospective study.Among them,18 cases were unilateral and 15 cases were bilateral.The operation and postoperative recovery of the two groups were compared.Result The median operation time for the axillary single-hole endoscopic surgery group was 88.67 minutes,the median extubation time was 4.40 days,and the median time for hospitalization was 7.67 days.In the traditional surgery group,the median operation time was 58.06 minutes,the median extubation time was 1.94 days,and the hospitalization median time was 4.89 days.There was no statistical difference between two groups(P>0.05).In terms of postoperative complications,there was no infection in both groups.There was one postoperative hematoma in the axillary approach single hole endoscopic group and 2 cases of partial nipple necrosis in the traditional surgical group.There was no significant difference in the incidence of postoperative hematoma and partial papillary necrosis between the two groups(P>0.05).In terms of postoperative satisfaction,13 patients in the axillary approach single-hole endoscopic group were rated as very satisfied with the postoperative appearance,and 5 patients in the traditional surgery group were very satisfied.There was a statistically significant difference between two groups(P=0.001).Conclusion Single-hole axillary endoscopic mastectomy for gynecomastia can be widely used in clinic,with better cosmetic effect and higher satisfaction.