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.	范林軍, 姜軍, 楊新華, 等. 全腔鏡乳房皮下腺體切除術: 附 96 例報告. 中華乳腺病雜志(電子版), 2008, 2(4): 407-416.
3.	顧成書, 管小青, 袁牧, 等. 腔鏡下行男性保留乳頭皮下全乳腺切除術的臨床價值. 中國腫瘤外科雜志, 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.	陳昕, 林金德, 靖昌瑞, 等. 腔鏡聯合脂肪抽吸術治療男性乳房發育癥. 中國美容醫學, 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, 邵穩喜, 等. 吸脂聯合腋窩入路腔鏡輔助手術治療男性乳房發育. 中華乳腺病雜志(電子版), 2015, 9(6): 408-409.
8.	賀青卿, 于芳, 范子義, 等. 達芬奇機器人乳房皮下腺體切除治療男性乳房發育癥一例. 中華內分泌外科雜志, 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.	中華醫學會外科學分會內分泌外科學組. 乳腺疾病腔鏡手術技術操作指南(2016 版). 中華乳腺病雜志(電子版), 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.	劉晨, 欒杰, 叢中, 等. 整形美容手術對男性乳腺發育癥患者心理影響的研究. 中國美容醫學, 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, 騰利, 岳紀良. 男子乳腺發育的治療進展. 中華整形外科雜志, 2005, 21(2): 148-151.
16.	牛兆河, 欒杰, 穆蘭花, 等. 男性乳腺發育癥的分度與治療. 整形再造外科雜志, 2006, 3(6): 78-80.
17.	王麗, 魏奉才, 胡振生, 等. 40 例男子乳房發育癥的手術治療. 中國現代普通外科進展, 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.	劉擎, 田延鋒, 李芳, 等. 乳腔鏡手術治療男性乳房發育癥 58 例報告.中國微創外科雜志, 2015, 15(2): 140-142.
23.	陳達鋒, 周松, 張雪惠, 等. 腔鏡手術治療男性乳房發育癥 21 例體會.東南國防醫藥, 2016, 18(2): 188-189.
24.	郭應祿. 談談手術標準化的重要性. 中華泌尿外科雜志, 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. 范林軍, 姜軍, 楊新華, 等. 全腔鏡乳房皮下腺體切除術: 附 96 例報告. 中華乳腺病雜志(電子版), 2008, 2(4): 407-416.
3. 顧成書, 管小青, 袁牧, 等. 腔鏡下行男性保留乳頭皮下全乳腺切除術的臨床價值. 中國腫瘤外科雜志, 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. 陳昕, 林金德, 靖昌瑞, 等. 腔鏡聯合脂肪抽吸術治療男性乳房發育癥. 中國美容醫學, 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, 邵穩喜, 等. 吸脂聯合腋窩入路腔鏡輔助手術治療男性乳房發育. 中華乳腺病雜志(電子版), 2015, 9(6): 408-409.
8. 賀青卿, 于芳, 范子義, 等. 達芬奇機器人乳房皮下腺體切除治療男性乳房發育癥一例. 中華內分泌外科雜志, 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. 中華醫學會外科學分會內分泌外科學組. 乳腺疾病腔鏡手術技術操作指南(2016 版). 中華乳腺病雜志(電子版), 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. 劉晨, 欒杰, 叢中, 等. 整形美容手術對男性乳腺發育癥患者心理影響的研究. 中國美容醫學, 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, 騰利, 岳紀良. 男子乳腺發育的治療進展. 中華整形外科雜志, 2005, 21(2): 148-151.
16. 牛兆河, 欒杰, 穆蘭花, 等. 男性乳腺發育癥的分度與治療. 整形再造外科雜志, 2006, 3(6): 78-80.
17. 王麗, 魏奉才, 胡振生, 等. 40 例男子乳房發育癥的手術治療. 中國現代普通外科進展, 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. 劉擎, 田延鋒, 李芳, 等. 乳腔鏡手術治療男性乳房發育癥 58 例報告.中國微創外科雜志, 2015, 15(2): 140-142.
23. 陳達鋒, 周松, 張雪惠, 等. 腔鏡手術治療男性乳房發育癥 21 例體會.東南國防醫藥, 2016, 18(2): 188-189.
24. 郭應祿. 談談手術標準化的重要性. 中華泌尿外科雜志, 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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