两种术式对治疗男性乳房发育症的临床分析

目的探讨肿胀吸脂联合乳晕下缘弧形小切口腺体切除术和微创旋切术治疗男性乳房肥大的临床疗效。方法自2001年1月至2013年10月，收治32例男性乳房肥大患者，随机分组分别采用肿胀吸脂联合乳晕下弧形切口腺体切除术和微创旋切术。结果1例患者于术后2d出现皮下血肿，经对症处理后最终一期愈合；1例乳头下乳腺组织残留过多，经二次整复后效果满意，其他病例切口均一期愈合。未见乳头、乳晕坏死及乳头感觉减退等并发症发生。22例患者随访，6—24个月，乳房外形良好，无复发。两组患者带管时间、并发症及术后瘢痕比较无明显统计学差异（P〉0．05），而微创旋切组费用较高、手术时间较长（P〈0．05）。结论真空辅助下微创旋切术和肿胀吸脂联合乳晕下弧形切口腺体切除术均具有瘢痕小、安全性高、外观自然、患者满意度高等优点，是目前治疗男性乳房发育有效方法。

Treatment of gynecomastia by a combined method of liposuction and semicircular periareolar incision glandular organ resection or minimally Invasive surgery

Objective To investigate the effect of the combined method of liposuction and semicircular periareolar inci- sion glandular organ resection or minimally invasive surgery in the treatment of gynecomastia. Methods From January 2001 to October 2013,32 patients, The levels of serum prolactin, luteinizing hormone, follicle stimulating hormone, estra- diol testosterone and eortisol were normal in 27 patients, while in the other 5 patients, the levels of serum prolactin,lute- inizing hormone ,follicle stimulating hormone and estradiol were higher than normal, and the testosterone level was lower. Liposuction combined semicircular periareolar incision glandular organ resection and minimally Invasive surgery were conducted in the 32 patients. Results Except for 2 cases in which one happened hematoma and in which the other breast tissue residues in excess under nipple then obtained healing by symptomatic treatment. There were no complication such as nipple and mammary areola necrosis, nipple hypesthesia. The 22 patients were followed up for 6 - 24 months. They were satisfied with their chest shape and no recurrence was observed. Conclusion The method of liposuction com- bined semicircular periareolar incision glandular organ resection and minimally Invasive surgery have advantages and dis- advantages in the treatment of gynecomastia,for example, there was no significant difference of complications and postop- erative scar with tube time, Minimally invasive group have higher costs, longer operation time characteristics In short, with two surgical methods are little sear, natural breast shape as well as high satisfaction. At present, it is effective meth- ods of treatment of gynecomastia.