探讨采用单孔腔镜经乳房后间隙入路手术切除乳腺肿块的临床疗效。

回顾性分析2022年3~8月成都市妇女儿童中心医院收治的较大乳腺肿块(≥2.5 cm)或乳腺多发病灶患者20例的临床资料。术前乳腺病灶影像学评估为BI-RADS 3类或4A类，均采用单孔腔镜经乳房后间隙入路手术切除肿块。以手术时间、并发症及外观满意度为主要指标进行临床疗效评估。

20例患者的手术时间为(118.0±34.1)min，术中出血为(15.3±7.3)ml。术后病理检查结果显示均为乳腺纤维腺瘤。术后随访(111.9±47.3)d，范围37~206 d。术后4例患者发生皮下气肿，无术后出血(瘀斑、血肿)、皮肤灼伤及切口感染。术后乳房外观手术瘢痕较小，美容效果好。19例的外观满意度评分为15分，1例为14分(总分15分)。

单孔腔镜经乳房后间隙入路肿块切除术是一种安全的乳腺腔镜手术，具备术中出血少、术后并发症发生率低、乳房外观满意度高等优点，适用于较大病灶、多发病灶或对术后乳房外观要求较高的患者。

To evaluate the clinical efficacy of single-port endoscopic resection of breast mass by retromammary space approach.

The clinical data of 20 patients with large breast masses (≥2.5 cm) or multiple breast lesions in the Chengdu Women’s and Children’s Central Hospital from March to August 2022 were retrospectively analyzed. The preoperative imaging evaluation confirmed breast lesions of BI-RADS 3 or 4A. All patients received the single-port endoscopic resection of breast mass by retromammary space approach. The clinical efficacy was evaluated by the following parameters: operation time, complications and patient satisfaction with breast appearance.

The operation time was (118.0±34.1) min, and intraoperative blood loss was (15.3±7.3) ml in 20 cases. The postoperative pathology confirmed breast fibroadenoma in 20 cases. All patients were followed up for (111.9±47.3) d (range: 37-206 d). After operation, 4 patients developed subcutaneous emphysema, but no postoperative bleeding (ecchymosis, hematoma), skin burns and incision infection were observed. The breast of affected side showed good cosmetic effect, with small surgical scars. The score of patient satisfaction was 15 in 19 cases and 14 in one case (total score: 15).

Single-port endoscopic resection by retromammary space approach has the advantages of less blood loss, low incidence of postoperative complications and high patient satisfaction, which is a safe option for patients with large mass or multiple lesions, or patients with high requirements for postoperative breast appearance.