背景:总结基于“5S”目标的“九步法”乳腔镜下乳房皮下切除术的经验,并规范该操作。
方法:在2002年1月1日至2021年10月31日之间,共1082名男性乳房发育症患者的2035个乳房,其中129名患者一侧,均接受乳腔镜皮下乳房切除术。随访终点为术后3个月。
结果:所有患者均顺利完成手术,他们都没有被转移到露天手术。单侧乳房的手术时间为12-28分钟,平均时间为17.7±6.2min。单侧手术过程中出血量很少,大约5-10毫升。术后引流总量为5~50ml,在3-5天内拔除引流管。0.3%乳头发生表皮坏死。0.2%的胸壁在乳房的超内侧区域有一点瘀斑。所有患者的乳头和乳晕感觉正常,平滑和对称的胸壁,和自然的轮廓。随访期间无复发。
结论:基于“5S”目标的“九步法”乳腔镜皮下乳房切除术治疗男性乳房发育症手术时间短,手术并发症少,美学效果好。它实现了“5S”目标,完全去除腺体组织(清扫),小的和疤痕隐藏的切口小(无疤痕),双侧胸壁良好的对称性(对称性),正常的胸部形状(形状),和平滑胸壁(平滑)。
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BACKGROUND: To summarize the experiences on the mastoscopic subcutaneous mastectomy for
gynecomastia by \"nine-step method\" based on the \"5S\" goal and standardize this operation.
METHODS: Between January 1, 2002, and October 31, 2021, a total of 2035 breasts of 1082 male patients with
gynecomastia, of which 129 patients with one side, were underwent mastoscopic subcutaneous mastectomy. The follow-up endpoint was 3 months after surgery.
RESULTS: All patients were successfully completed the operation, and none of them was transferred to open operation. The operation time for unilateral breast was 12-28 min, and the average time was 17.7 ± 6.2 min. The amount of bleeding during unilateral operation was very small, about 5-10 ml. The total drainage volume was 5-50 ml after the operation, and the drainage tube was removed in 3-5 days. The epidermal necrosis occurred in 0.3% nipple. 0.2% chest wall had a little ecchymosis in the supero-medial region of the breast. All patients had the normal feeling of nipples and areola, the smoothing and symmetrical chest wall, and the natural contour. There was no recurrence during the follow-up period.
CONCLUSIONS: The mastoscopic subcutaneous mastectomy for
gynecomastia by \"nine-step method\" based on the \"5S\" goal has a short operation time, few surgical complications and good esthetics. It achieves the \"5S\" goals on the complete removal of glandular tissue (sweeping), small and scar-hidden incision are small (scarless), good symmetry of bilateral chest wall (symmetry), normal chest shape (shape), and smoothing chest wall (smoothing).
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