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中华乳腺病杂志(电子版) ›› 2012, Vol. 06 ›› Issue (06) : 657 -663. doi: 10.3877/cma. j. issn.1674-0807.2012.06.008

论著

乳晕双环切口治疗乳腺囊性增生症伴乳房下垂
韩晶1, 全红1, 严伟国1, 丁涵之1   
  1. 1.200120 上海,同济大学附属东方医院乳腺外科
  • 收稿日期:2011-12-16 出版日期:2012-12-01

Treatment of breast cystic hyperplasia combined with mastoptosis through periareolar double-ring incision

Jing HAN1, Hong QUAN1, Wei-guo YAN1, Han-zhi DING1   

  1. 1.Department of Breast Surgery, East Hospital, College of Medicine, Tongji University, Shanghai 200120,China
  • Received:2011-12-16 Published:2012-12-01
引用本文:

韩晶, 全红, 严伟国, 丁涵之. 乳晕双环切口治疗乳腺囊性增生症伴乳房下垂[J/OL]. 中华乳腺病杂志(电子版), 2012, 06(06): 657-663.

Jing HAN, Hong QUAN, Wei-guo YAN, Han-zhi DING. Treatment of breast cystic hyperplasia combined with mastoptosis through periareolar double-ring incision[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2012, 06(06): 657-663.

目的

探讨沿乳晕双环法在肿块型乳腺囊性增生症伴乳房下垂治疗中的应用及其意义。

方法

患者取直立位设计切口:先确定新乳头的位置,画出外环,再以原乳头为中心,画出直径为3.5 ~4.0 cm 的内环。 之后,去除内外环之间的表皮,广泛分离乳房皮下组织,切除囊性增生病变,并将剩余乳腺组织塑形、悬吊。

结果

本方法治疗轻、中度乳房下垂的乳腺囊性增生症患者共45 例,术后乳房外形满意,乳头、乳晕血供和感觉良好,瘢痕不明显,效果良好。

结论

对于有需要手术的乳腺良性病变且伴有轻、中度乳房下垂的患者,采用沿乳晕的双环切口既可切除病变,又可悬吊乳房。其操作简便,效果满意。

Objective

To discuss the application and clinical significance of periareolar double-ring incision in the treatment of mass-typed breast cystic hyperplasia combined with mastoptosis.

Methods

The patient was in a standing position. The incision was designed in the following steps: firstly found the location of the new nipple, marked a outer circle, then draw an inner circle (3.5-4.0 cm in diameter) with the original nipple as its center. A rim of epidermis between the outer circle and inner circle was removed, and deep subcutaneous tissue was dissected, and the lesion with cystic hyperplasia was resected.The rest of breast tissue was then re-approximated and mastopexy was performed.

Results

From January 2007 to June 2011,45 patients with cystic hyperplasia combined with mild to moderate mastoptosis were operated by this method in our hospital. After surgery it produced satisfactory cosmetic breast contour, normal blood supply and sensory function of nippleareola complex, and unnoticeable scar.

Conclusions

For the benign breast lesions with mild to moderate mastoptosis which require surgery, the surgeon can both excise the lesion and perform mastopexy through periareolar double-ring incision. So the operation is simple and the outcome is satisfactory.

图1 设计示意图(术前患者取直立位) S 点:下皱折中点;P 线:锁骨中点与下皱折中点的连线;O 点:双上臂中点连线和P 线的交点,即新乳头位置。A 点:S 点体表投影以上2 cm,即外环上极;B 点: S 点体表投影以下5 ~7 cm,即外环下极;C 点:乳房外侧缘以内6 ~8 cm,即外环外侧点;D 点:胸骨中线以内7 ~9 cm,即外环内侧点。
图2 双侧外上象限肿块切除术伴乳房悬吊术(双环切口)前后对比 a,b: 术前,右侧乳房偏大;c,d: 术后2 周,可见双侧等大,悬吊效果较好,且瘢痕不明显
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