男性乳房发育乳晕缘小切口吸脂加皮下腺体切除术后并发症处理对策

Countermeasures of complications after liposuction and subcutaneous gland resection with small incision at the areola margin for gynecomastia

目的探讨男性乳房发育乳晕缘小切口吸脂加皮下腺体切除术后并发症的最佳处理对策,以减少和控制术后并发症的发生。方法收集2018-01-01-2022-08-31河南大学第一附属医院及医联体单位(636例)和韶关市第一人民医院(67例)收治的703例接受手术矫正男性乳房发育患者的临床资料。均采用乳晕缘小切口吸脂加皮下腺体切除术,观察手术效果及并发症发生情况。结果703例患者手术时间为26~180 min,术中出血量为10~15 mL,所有患者均顺利完成手术并在1周内出院。术后发生并发症49例,其中皮下血肿2例,皮下血清肿7例,乳头乳晕复合体(NAC)麻木3例,表皮水泡7例,感染1例,皮下积液5例,切口愈合不良5例,残余乳腺组织7例,胸廓外形不满意8例,瘢痕形成2例,双侧NAC不对称2例。49例患者术后并发症经对症处理后均得到满意效果。术后6个月随访患者对胸廓外形满意度,其中满意516例,较满意例179例,不满意8例,满意率为98.86%。结论男性乳房发育乳晕缘小切口吸脂加皮下腺体切除术后皮下血清肿、表皮水泡及残余乳腺组织等并发症发生率较高,但所有的术后并发症患者都能够接受,且经处理后均达到满意效果。

Objective To explore the best countermeasures of complications after liposuction and subcutaneous gland resection with small incision at the areola margin for gynecomastia,in order to reduce and control the occurrence of postoperative complications.Methods The clinical data of 703 patients who underwent surgical correction of gynecomastia admitted to the First Affiliated Hospital of Henan University and medical consortium units(636 cases)and Shaoguan First People's Hospital(67 cases)from January 1,2018 to August 31,2022 were retrospectively analyzed.All patients underwent liposuction and subcutaneous gland resection with small incision at the areola margin,to observe the surgical effect and incidence of complications.Results The operation time of the whole group was 26 to 180 minutes,the intraoperative bleeding volume was 10 to 15 ml,All patients successfully completed the surgery and were discharged within one week.There were 49 postoperative complications,including 2 cases of subcutaneous hematoma,7 cases of subcutaneous seroma,3 cases of numbness of nipple-areola complex(NAC),7 cases of epidermal blisters,1 case of infection,5 cases of subcutaneous hydrops,5 cases of poor wound healing,7 cases of residual breast tissue,8 cases of unsatisfactory thoracic appearance,2 cases of scar formation,and 2 cases of bilateral NAC asymmetry.The 49 patients with postoperative complications received satisfactory results after symptomatic treatment.After 6 months of follow-up,patients were satisfied with the appearance of the chest,with 516 satisfied,179 relatively satisfied,and 8 dissatisfied,with a satisfaction rate of 98.86%.Conclusions The incidence of complications such as subcutaneous seroma,epidermal blister and residual breast tissue after liposuction and subcutaneous gland resection with small incision at the areola margin a for gynecomastia is high,but all postoperative complications can be accepted by patients,and satisfactory results can be achieved after treatment.