经乳晕切口治疗多种乳腺良性疾病的探讨

目的 探讨经乳晕切口治疗多种乳房良性疾病的优势、适应证和手术技巧.方法 采用经乳晕切口治疗132例乳腺良性疾病（包括纤维腺瘤 91例,局限性腺体增厚12例,囊肿 8例,乳头溢液 13例, 良性乳腺叶状肿瘤2例,男性乳腺发育症6 例）.结果 本组术后都得到随访,其中107例对乳房外形和切口满意或非常满意,因觉切口较长不太满意19例,不满意正面切口的有6例.术后1个月复查乳头感觉正常117例,部分麻木15例.切口I/甲愈合130例,因局部血肿延迟愈合2例,无皮缘坏死、切口感染等并发症.结论 经乳晕切口可用于治疗多种乳腺良性疾病,并发症少,具有美容优势.在实施该手术的过程中应正确选择适应证、注意解剖层次,术后成型、适当引流、加压包扎都是手术成功需要考虑的因素.

Surgery for benign breast diseases through areolar incision

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.