[1]刘慧民,王金洪 ①.乳管镜协助硬膜外麻醉导管引导定位切除乳管内病变[J].中国微创外科杂志,2008,08(4):362-363.
　Liu Huimin*,Wang Jinhong..Breastduct Endoscopyassisted Epidural Catheterguided Tumor Localization for Resection of Intraductal Lesions[J].Chinese Journal of Minimally Invasive Surgery,2008,08(4):362-363.
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乳管镜协助硬膜外麻醉导管引导定位切除乳管内病变()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年4期
页码:
362-363
栏目:
出版日期:
2008-10-26

文章信息/Info

Title:
Breastduct Endoscopyassisted Epidural Catheterguided Tumor Localization for Resection of Intraductal Lesions
作者:
刘慧民; 王金洪 ①
甘肃省妇幼保健院乳腺科，兰州730050
Author(s):
Liu Huimin*;  Wang Jinhong.
*Department of Breast, Gansu Provincial Maternity and Childcare Hospital, Lanzhou 730050, China
关键词:
乳腺疾病; 纤维乳管镜; 硬膜外麻醉导管
Keywords:
Breast diseases; Breastduct endoscopy; Epidural catheter
分类号:
R655.8
文献标志码:
A
摘要:
目的探讨乳管镜协助下硬膜外麻醉导管引导定位切除乳管内病变的价值。方法纤维乳管镜诊断为乳管内肿瘤45例，定位其深度及体表方向。拔出乳管镜，在同一溢液导管内插入硬膜外麻醉导管做支撑引导，插入深度与纤维乳管镜插入深度一致。沿标记方向放射状切开乳头乳晕皮肤，硬膜外麻醉导管作支撑引导，解剖病变导管并切除。结果乳管镜诊断：导管内乳头状瘤41例，导管内多发乳头状瘤2例，乳头状瘤病2例。乳管镜诊断与病理诊断符合率：乳头状瘤95%（39/41），多发性乳头状瘤50%（1/2），乳头状瘤病50%（1/2）；诊断不符合者：病理诊断导管扩张，上皮增生2例，多发性导管内乳头状瘤伴非典型导管上皮增生、部分重度增生1例，乳腺癌1例。术后乳头乳房形态良好。结论乳管镜协助下硬膜外麻醉导管引导下行乳管内病变切除术，定位准确，病变切除容易，美容效果好，便于在基层医院开展。
Abstract:
ObjectiveTo explore the value of breastduct endoscopyassisted epidural catheterguided tumor localization in the resection of intraductal lesions.MethodsA total of 45 cases of breastduct endoscopyconfirmed intraductal tumor were enrolled in this study. After the depth and location of the tumor was determined, the endoscope was withdrawn and an epidural catheter was inserted into the duct with discharge at a same level to support the duct and guide the resection of the tumor. Then, the skin covering the nipple and areola were cut radially, and the diseased duct was resected under the guidance of a epidural catheter.ResultsThe ductoscopy showed intraductal papilloma in 41 cases, multiple intraductal papillomas in 2, and papillomatosis in 2. In the 41 patients with papilloma, the diagnosis was confirmed pathologically after the operation in 39 cases (95%), while in the 2 patients with multiple papillomas and the 2 with papillomatosis, the identical rate was both 50% (1/2). The misdiagnosed cases included 2 patients with epithelial hyperplasia, 1 with multiple intraductal papillomas complicated with atypical ductal hyperplasia and severe focal hyperplasia, and 1 patient with breast cancer. In all the cases, the shape of the breast and nipple were normal after the operation.ConclusionBreastduct endoscopyassisted epidural catheterguided tumor localization is worth being widely used for resection of intraductal lesions in local hospitals, for its precise localization, simple procedure, and good cosmetic outcomes.

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备注/Memo

备注/Memo:
①（云南省玉溪市第二人民医院外科，玉溪645100 ）
更新日期/Last Update: 2013-10-22