经腋窝单孔腔镜逆序法治疗男性乳房发育症的临床研究

Clinical study of reverse sequencing through axillary singlehole endoscopic in the treatment of gynecomastia

目的探讨经腋窝单孔腔镜逆序法治疗男性乳房发育症(GYN)的临床疗效。方法回顾性分析2019年4月至2022年3月滨州医学院附属滨州市中心医院收治的17例GYN患者的临床资料,根据治疗方法的不同分为观察组(n=9,12侧乳房),与对照组(n=8名,13侧乳房)。对照组行沿乳晕半环形切口开放单纯皮下腺体切除术,观察组行经腋窝单孔腔镜皮下腺体切除术,比较两组手术相关指标、术后并发症发生情况及美容效果。结果两组单侧手术时间、术中出血量、引流管拔管时间、术后疼痛评分及住院时间比较差异无统计学意义。两组术后并发症发生比较差异无统计学意义。术后6个月,两组乳房对称性、胸部外形、乳头感觉、皮肤情况评分及总分比较差异无统计学意义;观察组瘢痕情况评分高于对照组,差异有统计学意义(P<0.05)。结论经腋窝单孔腔镜技术治疗GYN效果确切,美容效果佳,安全性较高,可作为Simon≥Ⅱb级患者的首选手术方式之一,值得基层医院推广应用。

Objective To investigate the clinical efficacy of reverse sequencing through axillary single hole endoscopic in the treatment of gy-necomastia(GYN).Methods The clinical data of 17 patients with GYN admitted to Binzhou Central Hospital Affiliated to Binzhou Medical Col-lege from April 2019 to March 2022 were retrospectively analyzed,and they were divided into the observation group(n=9,12 breasts)and the con-trol group(n=8,13 breasts)according to the different treatment methods.The control group received simple subcutaneous gland resection along the areola semi-circular incision,the observation group received reverse sequencing through axillary single hole endoscopic,and the operation related in-dexes,postoperative complications and cosmetic effect were compared between the two groups.Results There were no significant differences in unilateral operation time,intraoperative blood loss,drainage tube extubation time,postoperative pain score and hospital stay between the two groups.There was no significant difference in postoperative complications between the two groups.6 months after surgery,there were no significant differ-ences in the scores of breast symmetry,breast shape,nipple sensation,skin condition and total score between the two groups;the score of scar condi-tion in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Re-verse sequencing through axillary single hole endoscopic in the treatment of GYN has definite effect,good cosmetic effect and high safety,can be used as one of the preferred surgical methods for Simon≥Ⅱb patients,and which is worth promotion and application in primary hospitals.