Clinic study of complete endoscopic subcutaneous mastectomy for gynecomastia by optimizing operation procedure_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Hong ¹ ,  LUO Jing ² ,  WU Jian ¹ , WANG Pin ¹ , ZHANG Wenjie ¹ , ZHANG Yan ¹ , XU Zhangbo ¹ , ZHANG Di ¹

1. Department of Thyroid & Breast Surgery, Affiliated Hospital of Southwest Jiaotong University / The Third People’s Hospital of Chengdu, Chengdu 610031, P. R. China;
2. Department of Thyroid & Breast Surgery, Maternal and Child Hospital of Sichuan Province, Chengdu 610045, P. R. China;

Corresponding author：

WU Jian, Email: wooj69@163.com

Keywords：

endoscopic; gynecomastia; mastectomy; optimizing operation procedure

DOI：

10.7507/1007-9424.201708123

Video：

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Objective To investigate effect of optimizing operation procedure (OOP) on surgical outcomes of complete endoscopic subcutaneous mastectomy (CESM) in treatment of gynecomastia. Methods A total of 217 patients with gynecomastia underwent CESM from January 2014 to March 2017 in the Third People’s Hospital of Chengdu were collected according to the criteria for inclusion and exclusion, further, based on a propensity score-matching model, a total of 94 patients were evenly assigned to OOP group (April 2015 later) and non-OOP group (before April 2015). The CESM with or without OOP was performed in the OOP group or the non-OOP group, respectively. The operative time, postoperative length of stay, treatment expenses, and favorable cosmetic effect were compared in these two groups. Results The differences in the general clinical data in both groups were not statistically significant (P>0.05). The operative time (min) was shorter (139.90±37.18versus 175.20±46.99, P=0.002), the postoperative length of stay (d) was shorter too (7.13±1.46 versus 8.47±2.71, P=0.021), and the treatment expenses (yuan) were more less (11 426.80±1 861.19 versus 12 315.75±1 306.64, P=0.036) in the OOP group as compared with the non-OOP group. Meanwhile the favorable cosmetic effect of the self-evaluation score in the OOP group was significantly higher than that in the non-OOP group (7.33±1.16 versus 5.97±1.16, P<0.05). Conclusion This study demonstrates that using optimizing standard CESM could shorten operative time, reduce treatment expenses, and improve satisfaction of patients.

Citation： LIU Hong, LUO Jing, WU Jian, WANG Pin, ZHANG Wenjie, ZHANG Yan, XU Zhangbo, ZHANG Di. Clinic study of complete endoscopic subcutaneous mastectomy for gynecomastia by optimizing operation procedure. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(3): 334-337. doi: 10.7507/1007-9424.201708123 Copy

1.	Yoshida Y, Yasuhara A, Hamada Y, et al. A case of idiopathic gynecomastia treated by endoscopic reduction mammoplasty. Clin Pediatr (Phila), 2001, 40(7): 421-422.
2.	范林军, 姜军, 杨新华, 等. 全腔镜乳房皮下腺体切除术: 附 96 例报告. 中华乳腺病杂志(电子版), 2008, 2(4): 407-416.
3.	顾成书, 管小青, 袁牧, 等. 腔镜下行男性保留乳头皮下全乳腺切除术的临床价值. 中国肿瘤外科杂志, 2014, 6(1): 16-18.
4.	Jarrar G, Peel A, Fahmy R, et al. Single incision endoscopic surgery for gynaecomastia. J Plast Reconstr Aesthet Surg, 2011, 64(9): e231-e236.
5.	陈昕, 林金德, 靖昌瑞, 等. 腔镜联合脂肪抽吸术治疗男性乳房发育症. 中国美容医学, 2013, 22(9): 906-908.
6.	Cao H, Yang ZX, Sun YH, et al. Endoscopic subcutaneous mastectomy: A novel and effective treatment for gynecomastia. Exp Ther Med, 2013, 5(6): 1683-1686.
7.	祝玉祥, 符德元, 邵稳喜, 等. 吸脂联合腋窝入路腔镜辅助手术治疗男性乳房发育. 中华乳腺病杂志(电子版), 2015, 9(6): 408-409.
8.	贺青卿, 于芳, 范子义, 等. 达芬奇机器人乳房皮下腺体切除治疗男性乳房发育症一例. 中华内分泌外科杂志, 2016, 10(2): 181-183.
9.	Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg, 1973, 51(1): 48-52.
10.	中华医学会外科学分会内分泌外科学组. 乳腺疾病腔镜手术技术操作指南(2016 版). 中华乳腺病杂志(电子版), 2016, 10(4): 193-199.
11.	Brown RH, Chang DK, Siy R, et al. Trends in the surgical correction of gynecomastia. Semin Plast Surg, 2015, 29(2): 122-130.
12.	Braunstein GD. Clinical practice. Gynecomastia. N Engl J Med, 2007, 357(12): 1229-1237.
13.	刘晨, 栾杰, 丛中, 等. 整形美容手术对男性乳腺发育症患者心理影响的研究. 中国美容医学, 2019, 19(5): 661-664.
14.	Rosen H, Webb ML, DiVasta AD, et al. Adolescent gynecomastia: not only an obesity issue. Plast Reconstr Surg, 2010, 64(5): 688-690.
15.	任敏, 腾利, 岳纪良. 男子乳腺发育的治疗进展. 中华整形外科杂志, 2005, 21(2): 148-151.
16.	牛兆河, 栾杰, 穆兰花, 等. 男性乳腺发育症的分度与治疗. 整形再造外科杂志, 2006, 3(6): 78-80.
17.	王丽, 魏奉才, 胡振生, 等. 40 例男子乳房发育症的手术治疗. 中国现代普通外科进展, 2012, 15(9): 749-750.
18.	Kasielska A, Antoszewski B. Surgical management of gynecomastia: an outcome analysis. Ann Plast Surg, 2013, 71(5): 471-475.
19.	Cuhaci N, Polat SB, Evranos B, et al. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab, 2014, 18(2): 150-158.
20.	Wolter A, Scholz T, Diedrichson J, et al. Surgical treatment of gynecomastia: an algorithm. Handchir Mikrochir Plast Chir, 2013, 45(2): 73-79.
21.	Fan L, Yang X, Zhang Y, et al. Endoscopic subcutaneous mastectomy for the treatment of gynecomastia: a report of 65 cases. Surg Laparosc Endosc Percutan Tech, 2009, 19(3): e85-e90.
22.	刘擎, 田延锋, 李芳, 等. 乳腔镜手术治疗男性乳房发育症 58 例报告.中国微创外科杂志, 2015, 15(2): 140-142.
23.	陈达锋, 周松, 张雪惠, 等. 腔镜手术治疗男性乳房发育症 21 例体会.东南国防医药, 2016, 18(2): 188-189.
24.	郭应禄. 谈谈手术标准化的重要性. 中华泌尿外科杂志, 200, 27(5): 293.
25.	Lapid O, Klinkenbijl JH, Oomen MW, et al. Gynaecomastia surgery in the Netherlands: what, why, who, where…. J Plast Reconstr Aesthet Surg, 2014, 67(5): 702-706.

1. Yoshida Y, Yasuhara A, Hamada Y, et al. A case of idiopathic gynecomastia treated by endoscopic reduction mammoplasty. Clin Pediatr (Phila), 2001, 40(7): 421-422.
2. 范林军, 姜军, 杨新华, 等. 全腔镜乳房皮下腺体切除术: 附 96 例报告. 中华乳腺病杂志(电子版), 2008, 2(4): 407-416.
3. 顾成书, 管小青, 袁牧, 等. 腔镜下行男性保留乳头皮下全乳腺切除术的临床价值. 中国肿瘤外科杂志, 2014, 6(1): 16-18.
4. Jarrar G, Peel A, Fahmy R, et al. Single incision endoscopic surgery for gynaecomastia. J Plast Reconstr Aesthet Surg, 2011, 64(9): e231-e236.
5. 陈昕, 林金德, 靖昌瑞, 等. 腔镜联合脂肪抽吸术治疗男性乳房发育症. 中国美容医学, 2013, 22(9): 906-908.
6. Cao H, Yang ZX, Sun YH, et al. Endoscopic subcutaneous mastectomy: A novel and effective treatment for gynecomastia. Exp Ther Med, 2013, 5(6): 1683-1686.
7. 祝玉祥, 符德元, 邵稳喜, 等. 吸脂联合腋窝入路腔镜辅助手术治疗男性乳房发育. 中华乳腺病杂志(电子版), 2015, 9(6): 408-409.
8. 贺青卿, 于芳, 范子义, 等. 达芬奇机器人乳房皮下腺体切除治疗男性乳房发育症一例. 中华内分泌外科杂志, 2016, 10(2): 181-183.
9. Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg, 1973, 51(1): 48-52.
10. 中华医学会外科学分会内分泌外科学组. 乳腺疾病腔镜手术技术操作指南(2016 版). 中华乳腺病杂志(电子版), 2016, 10(4): 193-199.
11. Brown RH, Chang DK, Siy R, et al. Trends in the surgical correction of gynecomastia. Semin Plast Surg, 2015, 29(2): 122-130.
12. Braunstein GD. Clinical practice. Gynecomastia. N Engl J Med, 2007, 357(12): 1229-1237.
13. 刘晨, 栾杰, 丛中, 等. 整形美容手术对男性乳腺发育症患者心理影响的研究. 中国美容医学, 2019, 19(5): 661-664.
14. Rosen H, Webb ML, DiVasta AD, et al. Adolescent gynecomastia: not only an obesity issue. Plast Reconstr Surg, 2010, 64(5): 688-690.
15. 任敏, 腾利, 岳纪良. 男子乳腺发育的治疗进展. 中华整形外科杂志, 2005, 21(2): 148-151.
16. 牛兆河, 栾杰, 穆兰花, 等. 男性乳腺发育症的分度与治疗. 整形再造外科杂志, 2006, 3(6): 78-80.
17. 王丽, 魏奉才, 胡振生, 等. 40 例男子乳房发育症的手术治疗. 中国现代普通外科进展, 2012, 15(9): 749-750.
18. Kasielska A, Antoszewski B. Surgical management of gynecomastia: an outcome analysis. Ann Plast Surg, 2013, 71(5): 471-475.
19. Cuhaci N, Polat SB, Evranos B, et al. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab, 2014, 18(2): 150-158.
20. Wolter A, Scholz T, Diedrichson J, et al. Surgical treatment of gynecomastia: an algorithm. Handchir Mikrochir Plast Chir, 2013, 45(2): 73-79.
21. Fan L, Yang X, Zhang Y, et al. Endoscopic subcutaneous mastectomy for the treatment of gynecomastia: a report of 65 cases. Surg Laparosc Endosc Percutan Tech, 2009, 19(3): e85-e90.
22. 刘擎, 田延锋, 李芳, 等. 乳腔镜手术治疗男性乳房发育症 58 例报告.中国微创外科杂志, 2015, 15(2): 140-142.
23. 陈达锋, 周松, 张雪惠, 等. 腔镜手术治疗男性乳房发育症 21 例体会.东南国防医药, 2016, 18(2): 188-189.
24. 郭应禄. 谈谈手术标准化的重要性. 中华泌尿外科杂志, 200, 27(5): 293.
25. Lapid O, Klinkenbijl JH, Oomen MW, et al. Gynaecomastia surgery in the Netherlands: what, why, who, where…. J Plast Reconstr Aesthet Surg, 2014, 67(5): 702-706.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinic study of complete endoscopic subcutaneous mastectomy for gynecomastia by optimizing operation procedure

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