乳腔镜腋窝入路与传统乳晕切口手术治疗男性乳腺发育症的临床对照研究

目的对比乳腔镜腋窝入路与传统乳晕切口在男性乳腺发育症手术治疗上的临床效果。方法回顾性分析2017年3月至2018年3月46例在长治医学院附属和平医院确诊为男性乳腺发育症的患者,行乳腔镜下乳房皮下腺体切除术和传统乳晕切口手术的临床资料,对比腔镜组与传统组术式在术中出血量、手术时间、拔管时间、平均住院时间、术后近期并发症情况、住院总费用、术后6个月满意度等情况。组间计数资料比较采用χ2检验,组间计量资料比较采用配对t检验,统计学处理采用SPSS18.0统计学软件包辅助分析。结果两组患者均顺利完成手术,并在年龄(t=-0.550,P=0.473)、BMI(t=0.695,P=0.353)、病变位置(χ2=1.657,P=0.198)及Simon分类(χ2=0.762,P=0.683)上差异无统计学意义;腔镜组与传统组患者在手术时间(t=-0.528,P=0.596)、术中出血量(t=0.489,P=0.999)、拔管时间(t=-0.148,P=0.755)、术后近期并发症情况(t=0.453,P=0.370)、平均住院时间(t=-0.450,P=0.676)、住院总费用(t=-0.340,P=0.486)上差异无统计学意义;术后6个月满意度对比,差异有统计学意义(P=0.012)。结论乳腔镜手术治疗男性乳腺发育症较传统开放手术微创美观,且较为安全,可在临床推广应用。

A clinical comparative study of axillary mastoscopic mastectomy and traditional areola incision in treatment of gynecomastia

Objective To compare the clinical effects of the two methods in surgical treatment of gynecomastia.Methods The clinical data of 46 patients with gynecomastia were retrospectively analyzed,who received total removal of the glands through mastoscopic assistance(mastoscopic group)or traditional areola incision(traditional group)from Mar.2017 to Mar.2018.The two groups were compared in terms of blood loss,the mean operation duration,extubation time,the average hospitalization time,postoperative complications,the total cost and patients’satisfaction at 6 month after operation.Chi-square test was used to compare the count data between groups,paired t test was used to compare the measurement data between groups,and SPSS18.0 statistical software was used for statistical analysis.Results The operation was completed in both groups.There were no differences between the two group in age(0.473),BMI(0.353),lesion location(0.198),Simon classification(0.683),the mean blood loss(P=0.999),mean operation duration(P=0.596),extubation time(P=0.755),the average hospitalization time(P=0.676),postoperative complications and(P=0.370)or the total cost(P=0.486).The difference of patients’satisfaction at 6 month after operation had statistical significance(P=0.012).conclusion Compared with traditional open surgery,mastoscopic surgery for gynecomastia is minimally invasive,beautiful and safe,which can be widely used in clinical practice.