目的

探讨超声引导下真空辅助微创旋切系统治疗乳腺良性叶状肿瘤的有效性及安全性。

方法

按随机数字表法选取2009 年1 月至2011 年1 月在首都医科大学附属复兴医院治疗的乳腺良性叶状肿瘤(直径≤30 mm)患者42 例进行前瞻性研究,均为女性。 根据患者意愿分为超声引导下真空辅助微创旋切手术组(微创组,21 例)及常规局部切除手术组(对照组,21 例)。 手术时间、术中出血量、伤口长度等指标为偏态分布,采用Mann-Whitney 检验,两组术后感染、出血、瘀斑、局部复发例数的比较采用χ² 检验。

结果

微创组患者手术时间、术中出血量、伤口长度等指标均优于对照组[(28.57±5.04) min 比(37.62±10.44) min,(20.00±9.49) ml 比(31.90±14.70) ml, (4.00±0.89) mm 比(20.00±4.47) mm,Z=-2.896,-2.739,-5.650,P 均＜0.050]。 微创组患者术后感染、出血、瘀斑及局部复发例数分别为1、1、2、4 例,对照组为4、3、4、2 例,差异无统计学意义(χ²=0.908、0.276、0.194、0.194,P 均＞0.050)。 微创组患者均对乳房术后外观表示满意(100%,21/21),对照组15 例满意(71.4%, 15/21),差异有统计学意义(χ² =4.861, P=0.027)。

结论

超声引导下真空辅助微创旋切系统治疗直径≤30 mm 的乳腺良性叶状肿瘤,具有手术切除范围准确、手术创伤小、术后恢复快、美容效果好等优点,优于传统局部扩大切除术。

Objective

To investigate the efficacy and safety of ultrasound-guided vacuum-assisted minimally invasive treatment for benign breast phyllodes tumor.

Methods

We enrolled 42 female patients with benign breast phyllodes tumor (diameter≤30 mm) treated in Fuxing Hospital, Capital Medical University from January 2009 to January 2011 by random number table for a prospective study. According to the patients'will,they were divided into 2 groups: minimally invasive group (21 cases) treated by ultrasound-guided vacuumassisted minimally invasive biopsy system, and control group (21 cases) treated by conventional local resection. Because of non-normal distribution, the parameters including operative time, blood loss and wound length were analyzed using Mann-Whitney test. The cases of postoperative infection, bleeding, bruising and local recurrence between two groups were compared using χ² test.

Results

The operative time, blood loss and wound length in minimally invasive group were superior to those in control group [(28.57±5.04) min vs(37.62±10.44) min, (20.00±9.49) ml vs (31.90±14.70) ml, (4.00±0.89) mm vs (20.00±4.47) mm],and the differences were statistically significant (Z = -2.896,-2.739,-5.650, all P＜0.050). After operation, there was 1 patient with postoperative infection, 1 with bleeding, 2 with bruising and 4 with local recurrence in minimally invasive group, 4, 3, 4, 2 in control group, respectively, indicating no significant difference (χ²=0.908,0.276,0.194,0.194, all P＞0.050). All patients in minimally invasive group were satisfactory with the appearance of breast (100%, 21/21), 15 in control group (71.4%, 15/21), and the difference was statistically significant (χ²=0.908, P=0.027).

Conclusion

For benign breast phyllodes with tumor diameter ≤30 mm, ultrasound-guided vacuum-assisted minimally invasive biopsy system has the advantages of precise resection, less trauma, rapid recovery and better cosmetic results over conventional local resection.