经腋前线单切口腔镜辅助乳腺纤维瘤手术与常规手术的比较

目的探讨经腋前线单切口腔镜辅助乳腺手术（video-assistedbreastsurgery，VABS）切除乳腺纤维瘤的安全性与可行性。方法回顾性分析2012年1月～2014年3月30例乳腺纤维瘤手术情况，按照病人意愿行经腋前线VABS或经乳晕切口常规手术，比较手术相关参数和手术并发症的发生率。结果本组30例均完成手术，其中腔镜组17例，常规组13例，2组年龄、病灶大小等差异无显著性。无手术并发症发生。2组手术时间、出血量和住院时间差异无显著性。腔镜组切口至病灶远端距离明显长于常规组[（8．7±2．7）cmVS．（1．4±1．1）cm，t=9．234，P=0．000]。腔镜组中切口到病灶距离≤8．0cm者（n=8）手术时间明显短于〉8．0cm者（n=9）[中位数22（13～38）min VS．45（11～58）min，Z=2．215，P=0．027]。结论经腋前线VABS在乳腺纤维瘤的病灶切除中有与常规手术相似的安全性和可操作性，更适合乳房外侧象限病灶切除。

A Comparison Study of Video-assisted Breast Surgery Conventional Resection for Adenofibroma

Objective To explore the feasibility and safety of video-assisted breast surgery （VABS） through single incision on the anterior axillary line, as compared with conventional resection, for adenofibroma. Methods From January 2012 to March 2014, a retrospective analysis of 30 cases of adenofibroma treated either by conventional resection through areola incision （CT group） or by VABS through the single incision on anterior axillary line （VA group） was carried out. The surgery-related parameters and the incidence of postoperative complications were compared between the two groups. Results All the 30 patients underwent the surgical procedure successfully, including 13 patients belonging to CT group and 17 patients, YA group. The age, the size of lesions, and the incision length had no significant differences between the two groups. No postoperative complications occurred in all the patients. The operation time, intraoperative blood loss and length of hospital stay were not statistically significant between the two groups. The maximum distance （MaxD） from incision to lesion was significantly longer in the VA group than that in the CT group [ （8.7 ± 2.7 ） cm vs. （1.4±1.1） cm, t=9.234, P=0.000]. The operative time in patients with MaxD≤8.0 cm （n=8） was significantly shorter than that in patients with MaxD〉8.0 cm （n=9） [median, 22 （13 -38） rain vs. 45 （11 -58） rain, Z=2.215, P=0.027]. Conclusions Video-assisted breast surgery through single incision on the anterior axillary line has the similar safety and feasibility with conventional resection. It is more suitable for removing the lesions in the outer quadrant of the breast.