Abstract:

Objective

To investigate the clinical outcome of minimally invasive biopsy combined with liposuction in treatment of gynecomastia.

Methods

It was a retrospective study. Totally 100 cases of gynecomastia treated in the Department of Breast Surgery, People's Hospital of Zhengzhou University from January 2014 to December 2015 were analyzed according to inclusion and exclusion criteria. The patients were divided into two groups: group A (n=54) and group B (n=46) according to the operation methods. In group A, the patients underwent minimally invasive biopsy to excise mammary gland. In group B, vacuum liposuction was firstly given to remove excess fatty tissue, then minimally invasive biopsy to remove glandular tissue. The operation time, times of minimally invasive excisions, intraoperative blood loss, postoperative complications(2 weeks) and patients' satisfaction within postoperative 6 months were recorded. χ² test was used to compare postoperative complications between two groups and t test was used to compare the operation time, times of minimally invasive excisions, intraoperative blood loss and patients' satisfaction within postoperative 6 months.

Results

The operation time was (51.55 ± 7.67) min in group A and (34.55 ± 5.75) min in group B,indicating a significant difference (t=5.880, P ＜0.001). The times of minimally invasive excisions was(122.91±19.10) in group A and (48.83 ± 9.91) in group B, indicating a significant difference(t=11.519,P＜0.001). The intraoperative blood loss was (33.64±9.98)ml in group A and(30.45±9.08)ml in group B,indicating no significant difference(t=0.782,P=0.443). Within postoperative 2 weeks, nine patients in group A and five patients in group B had subcutaneous fluid, which was relieved after syringe aspiration and pressure dressing,and the two groups showed no significant difference (χ²=0.693,P=0.405). Seven patients in group A had local hematoma, which was improved after absorption, while none in group B was observed with local hematoma, suggesting a significant difference (P=0.014). In 6-month follow-up, the score in bilateral symmetry satisfaction was (7.18 ± 1.25) in group A and (8.25 ± 0.87) in group B, suggesting a significant difference (t=-2.361,P=0.030); the score in satisfaction to skin and nipple sensation in surgical field was(7.55 ± 1.27) in group A and (7.67 ± 1.30) in group B, suggesting no significant difference (t=-0.202,P=0.842); the score in overall satisfaction was (7.09 ± 1.38) in group A and (8.42 ± 1.24) in group B,suggesting a significant difference (t= -2.420,P = 0.025).

Conclusion

The combination of minimally invasive biopsy and liposuction in treatment of gynecomastia has the advantages of short operative time, less postoperative complications, high patients' satisfaction and favorable clinical outcome.

Key words: Mammary glands,human, Gynecomastia, Surgical procedures, minimally invasive