背景:目前,一个标准,男性乳房发育症仍然缺乏最佳的手术方法。尽管各种外科手术的发展,这些技术通常仅限于SimonI和II的患者.本研究旨在介绍一种针对所有类型和等级的男性乳房发育症的新技术,并报告了初步结果。
方法:从2021年3月至2023年3月接受单腋下切口反向序列内窥镜保留乳头乳房切除术(R-E-NSM)的患者在一个机构进行招募。前瞻性地收集并分析了3个月随访截止的数据,以确定该技术的短期美学和安全性结果。以及学习曲线。
结果:在81例男性乳房发育症患者中,共进行了159例单腋下切口逆序内镜保留乳头的乳房切除术。在这81名患者中,7例患者(8.6%)被归类为西蒙一级,29例(35.8%)为IIa级,24名患者(29.6%)为IIb级,21例(25.9%)为III级。在患者报告的美容结果中,总体满意度得分为8.4±1.4。共有74.1%的患者表示高度满意,和25.9%的人感到满意。总并发症发生率为10.1%,只有1例患者出现严重并发症。根据累积和图分析,外科医生B需要大约12例,外科医生C需要11例,以大大减少手术时间。
结论:R-E-NSM对所有Simon级男性乳房发育症患者都是安全有效的,具有出色的美容效果和较短的学习曲线。然而,仍然需要进行长期的后续评估。
方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
BACKGROUND: Currently, a standard, optimal surgical procedure is still lacking for
gynecomastia. Despite the development of a variety of surgical interventions, these techniques were often limited to patients with Simon I and II. The present study aimed to introduce a novel technique for all types and grades of
gynecomastia, and reported the preliminary results.
METHODS: Patients who received single axillary incision reverse sequence endoscopic nipple-sparing mastectomy (R-E-NSM) from March 2021 to March 2023 were enrolled at a single institution. The data from 3-month follow-up cut-off were collected prospectively and analyzed to determine the short-term esthetic and safety results of this technique, as well as the learning curve.
RESULTS: A total of 159 single axillary incision reverse sequence endoscopic nipple-sparing mastectomy procedures were performed in 81
gynecomastia patients. Among these 81 patients, 7 patients (8.6%) were classified as Simon grade I, 29 patients (35.8%) as grade IIa, 24 patients (29.6%) as grade IIb, and 21 patients (25.9%) as grade III. In the patient-reported cosmetic results, the overall satisfaction score was 8.4 ± 1.4. A total of 74.1% of patients were highly satisfied, and 25.9% were satisfied. The overall complication rate was 10.1%, and only 1 patient had a major complication. According to the cumulative sum plot analysis, approximately 12 cases were needed for surgeon B and 11 cases for surgeon C to decrease their operation time significantly.
CONCLUSIONS: R-E-NSM is safe and effective for all Simon grade
gynecomastia patients, with excellent cosmetic results and a short learning curve. However, a long-term follow-up assessment is still needed.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .