比较经腋窝溶脂单孔腔镜皮下乳腺切除术与传统经乳晕皮下乳腺切除术治疗男性乳腺发育症（GM）患者的效果，并评估术后满意度。

回顾性分析2023年1月至2024年8月常州市第一人民医院行手术治疗的55例GM患者临床资料，根据手术方式分为腔镜手术组（采用经腋窝溶脂单孔腔镜皮下乳腺切除术，23例）和传统手术组（采用传统经乳晕皮下乳腺切除术，32例）。对比分析两组患者的手术切口长度、术中出血量、手术时间、拔管时间、住院时间、并发症发生率等情况。术后3个月，采用BODY-Q量表从胸部、乳头、瘢痕、身体形象、社交以及外观相关困扰6个方面评价术后患者满意度。符合正态分布的计量资料组间比较采用独立样本t检验，不符合正态分布的计量资料组间比较采用非参数检验。计数资料组间比较采用 χ²检验或Fisher确切概率法。

腔镜手术组患者切口长度显著小于传统手术组［3.0（3.0，3.0） cm比4.0（3.5，4.0） cm，Z=-5.574，P<0.001］，患病部位为单侧和双侧患者术中出血量均低于传统手术组［单侧：（11.7±2.9） ml比（24.3±7.3） ml，t=-2.813，P=0.023；双侧：（20.4±6.5） ml比（32.2±8.3） ml，t=-5.206，P<0.001］，拔管时间显著短于传统手术组［（3.4±0.6）d比（4.0±0.8）d，t=-2.969，P=0.004］，但手术时间长于传统手术组［单侧：（100±20） min比（50±16） min，t=4.228，P=0.003；双侧：（215±31） min比（94±27） min，t=13.957，P<0.001］。腔镜手术组和传统手术组患者住院时间和并发症发生情况比较，差异均无统计学意义［（3.9±0.9）d比（3.7±1.3）d，t=0.695，P=0.490；17.4%（4/23)比9.4%（3/32），P=0.435］。BODY-Q量表评估结果显示：腔镜手术组和传统手术组瘢痕评分分别为（77±13）分和（66±12）分，差异有统计学意义（t=3.130，P=0.003）；两组患者在胸部、乳头、身体形象、社交和外观相关困扰维度评分比较，差异均无统计学意义（P>0.05）。

GM患者采用经腋窝溶脂单孔腔镜皮下乳腺切除术较传统经乳晕皮下乳腺切除术疗效更好，术后满意度更高。

To compare the clinical efficacy between axillary liposuction combined with single-port endoscopic subcutaneous mastectomy and traditional periareolar subcutaneous mastectomy in the treatment of gynecomastia （GM），and assess postoperative satisfaction.

A retrospective analysis was conducted on the clinical data of 55 patients with GM who underwent surgical treatment in the Changzhou First People's Hospital from January 2023 to August 2024. According to the surgical approach，the patients were divided into the endoscopic surgery group （receiving axillary liposuction combined with single-port endoscopic subcutaneous mastectomy，23 cases） and the traditional surgery group （receiving traditional periareolar subcutaneous mastectomy，32 cases）. The two groups were compared in terms of incision length，intraoperative blood loss，operation duration，extubation time，hospital stay and complication rate. At 3 months postoperatively，the BODY-Q scale was adopted to assess postoperative satisfaction from six dimensions，including chest，nipple，scar，body image，social interaction，and appearance-related distress. For the comparison of normally distributed continuous data between groups，the independent sample t test was used. For the comparison of non-normally distributed continuous data between groups，nonparametric test was adopted. For the comparison of categorical data between groups， χ² test or Fisher's exact test was employed.

The incision length in the endoscopic surgery group was significantly shorter than that in the traditional surgery group ［3.0 （3.0，3.0） cm vs 4.0 （3.5，4.0） cm，Z=-5.574，P<0.001］.The endoscopic surgery group had significantly less intraoperative blood loss ［unilateral： （11.7±2.9） ml vs （24.3±7.3） ml，t=-2.813，P=0.023； bilateral： （20.4±6.5） ml vs （32.2±8.3） ml，t=-5.206，P<0.001］，and significantly shorter extubation time compared with the traditional surgery group ［（3.4±0.6） d vs （4.0±0.8） d，t=-2.969，P=0.004］，while the operation time was significantly longer ［unilateral： （100±20） min vs （50±16） min，t=4.228，P=0.003； bilateral： （215±31） min vs （94±27） min，t=13.957，P<0.001］. there were no significant differences in hospital stay or complication incidence between the two groups ［（3.9±0.9） d vs （3.7±1.3） d，t=0.695，P=0.490； 17.4%（4/23) vs 9.4%（3/32），P=0.435］. The results of BODY-Q scale assessment showed the scar score was 77±13 in the endoscopic surgery group and 66±12 in the traditional surgery group，indicating a significant difference （t=3.130，P=0.003），and no significant difference was observed in scores of chest，nipple，body image，social interaction，and appearance-related distress dimensions between the two groups （all P>0.05）.

Axillary liposuction combined with single-port endoscopic subcutaneous mastectomy brings better clinical outcome and postoperative patient satisfaction in GM patients compared with traditional periareolar subcutaneous mastectomy.