ABSTRACT
Objective To evaluate the effect of ultrasound-guided vacuum-assisted minimal invasive resection(Mammotome procedure)of breast lumps through the retromammary space. Methods Seven hundred and eighty-seven patients in Obstetrics and Gynecology Hospital Affiliated to Fudan University from Jan. 2011 to May 2012 were underwent ultrasound-guided Mammotome operation through the retromammary space (retromammary space group,385 cases),or adjacent the lumps,and followed by post-operation visits regularly (Mammotome operation adjacent the lumps group,402 cases). The operation effects were compared between the two groups. Results All cases were followed up for 12 months. The period of Mmmotome operation through the retromam mary space and the rate of resection were(48 ± 6)min and(52 ± 4)min,99. 48%(383 / 385), 99. 25%(399 / 402),perspectively,in group of Mammotome operation through the retromammary space and Mammotome operation adjacent lumpsand. There was no significant difference between the two groups( P> 0. 05). The amount of procedural bleeding,the incidence of ecchymosis,local hematoma and the number of incision in group of Mammotome operation through the retromammary space were(8 ± 3)ml,2. 34%(9 / 385), 0. 52%(2 / 385),(1. 3 ± 0. 6)respectively,which were significantly lower than those in Mammotome operation adjacent the lumps group((14 ± 6)ml,8. 71%(35 / 402),2. 74%(11 / 402),(2. 4 ± 0. 3)respectively). There were statistical difference between two groups( P = 0. 003,P < 0. 001,P = 0. 001,P = 0. 006). The rate of satisfaction in group of Mammotome operation through the retro-mammary space was 98. 70%(380 / 385),which is significantly higher than in group of Mammotome operation adjacent the lumps(89. 30%(359 / 402),P< 0. 01). Conclusion The therapy approach of ultrasound-guided Mammotome operation through the retromammary space has lower hemorrhagic complication,as well as the better effect with special advantages. Therefore it has prospective clinical application.
ABSTRACT
Objective To investigate the feasibility of laparoscopic extirpation for mammary multiple fibroadenoma. Methods A total of 12 patients with multiple fibroadenoma that were diagnosed by ultrasonography and fine needle aspiration were enrolled in this study. Through an axillary small incision, the air was inflated into the retromammary space, which had been obtusely separated to build a surgical space. Then, 58 fibroadenomas were resected under a laparoscope. Frozen-section examination was carried out during the operation. Results All the masses of the 12 patients were laparoscopically extirpated successfully, without operative complications. The operation time was 40-150 minutes with a mean of 80 minutes. One month after the operation, the shape of the breast looked well and the sensation of the nipple remained normal. During a 1- to 36-month follow-up (mean 18.5 months), none of the patients had scars on the breast or tumor recurrence. All of them were satisfied with the cosmetic results. Conclusion Laparoscopic extirpation of mammary multiple fibroadenoma through the retromammary space is safe and feasible.