内窥镜下微创清除注射的隆乳聚丙烯酰胺水凝胶

目的：内窥镜辅助下探查聚丙烯酰胺水凝胶注射隆乳术后形成的囊腔、结节的临床效果，以提高水凝胶的清除率。方法：自2003年5月-2007年4月，本院整形外科在内窥镜辅助下微创清除注射隆乳聚丙烯酰胺水凝胶16例，术前常规行乳腺B超检查，必要时还需行MRI或增强CT检查，了解水凝胶的所在层次和分布范围。全部采用乳晕下缘切口，内窥镜辅助直视下探查注射隆乳术后形成的囊腔、结节，清除水凝胶。结果：16例患者伤口全部一期愈合，无血肿、感染并发症。术后随诊6～24个月，双侧乳房扁平对称，乳房包块结节、胸部疼痛等并发症基本消失，乳腺B超检查均未发现典型水凝胶残留声像。结论：内窥镜辅助下可以提高水凝胶的清除率，具有安全、可靠、创伤小、出血少等优点，值得推广。

Mini-invasive Endoscopy for Removal of Polyacrylamide Hydrogel Residuals from Failed Breast Augmentation

Objective： To evaluate the clinical use of endoscopic exploration for removal of polyacrylamide hydrogel （PAMH） residuals from failed breast augmentation. Methods： Between May 2003 and April 2007, endoscopy-assisted operations for removal of PAMH were performed in 16 patients who had a failed breast augmentation. Prior to the procedure, all patients underwent B-type ultrasonography of the breast, and if necessary, magnetic resonance imaging or enhanced CT, to evaluate the distribution of PAMH. Endoscopic surgery under direct vision was completed through a sub-areolar incision for exploration of cysts and nodules from the failed augmentation and for clearance of PAMH in all cases, Results： Primary closure of the incision was achieved in all 16 cases. None of the patients experienced hematoma or infection. Follow-up for 6-24 months showed symmetrical, flat breasts and almost resolution of lumps or pains in all cases. No PAMH residuals were found with uhrasonography. Conclusion： Endoscopy-assisted operation appears to be safe and reliable in boosting clearance of PAMH and with less morbidity and blood loss, which warrants its widespread use.