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目的:探讨超声引导下麦默通旋切系统对乳腺导管内乳头状瘤(IP)的诊断与治疗价值。方法:回顾性分析2008年8月至2011年9月广州医学院第一附属医院收治的31例(35个病灶)IP患者的临床资料,均采用超声引导下麦默通旋切系统进行诊断和治疗。结果:所有病灶定位准确,手术时间5~20 nin,平均手术时间(9.2±12.7)min。术中及术后患者均无明显疼痛,术后无血肿形成。病理检查示6例(19.4%)为不典型IP,接受开放手术切除,其中1例(16.7%)为浸润性导管癌,改行单纯乳房切除+前哨淋巴结活检术;25例(80.6%)为良性IP,接受定期超声检查。术后3个月复查,患者伤口均愈合良好,无明显疤痕形成。1例术后15个月复发,接受开放手术切除。结论:超声引导下麦默通旋切系统可准确定位并切除IP,具有微创、美观、并发症少等优点,值得进一步推广。当病理为不典型导管内乳头状瘤时,需进一步行开放手术切除。
Objective: To investigate the diagnosis and treatment of breast ductal papilloma (IP) under the guidance of ultrasound-guided Maarten rotary system. Methods: The clinical data of 31 patients (35 lesions) with IP who were admitted to the First Affiliated Hospital of Guangzhou Medical College from August 2008 to September 2011 were retrospectively analyzed. All of them were diagnosed by ultrasound-guided MacMillan rotation system treatment. Results: All the lesions were accurately located. The operation time was 5 to 20 nin and the average operation time was 9.2 ± 12.7 min. No intraoperative and postoperative patients with pain, no hematoma after surgery. One case (16.7%) was invasive ductal carcinoma and was treated by simple mastectomy + sentinel lymph node biopsy. Twenty-five cases (80.6%) were benign IP, subject to regular ultrasound examination. After 3 months of review, the wounds of patients all healed well without obvious scar formation. One patient recurred 15 months after operation and underwent open surgery. Conclusion: Ultrasound-guided mesomectomy can precisely locate and excise IP, which has the advantages of minimally invasive, aesthetic and less complications, which is worth further promotion. When the pathology is not typical of intraductal papilloma, need further open surgery.