Objective: To observe the efficacy of different surgical protocols in the management of multiple benign breast nodules. Methods: Patients diagnosed with multiple benign breast nodules from 2021.4 to 2023.2 were divided into two groups, blank and study groups, each with 51 cases, and treated with conventional open and ultrasound-guided minimally invasive rotational surgery respectively. Results: The study group had better incision diameter and VAS score at 24h postoperatively than the blank group, with significant differences (P &lt; 0.05). Regarding the postoperative complication rate index, the study group vs. the blank group was 3.92% vs. 21.57% (P &lt; 0.05). Conclusion: Minimally invasive spinotomy under ultrasound guidance for the treatment of patients with multiple breast nodules is safe and effective and has the potential to be used universally

Fan, Rong

Wang, Zhuo

Wu, Zhu

Ye, Qingqing

English

Advanced Emergency Medicine (E-Journal)

Volume 12 | Issue 1 -1-Effectiveness of Ultrasound-Guided Minimally InvasiveSpinotomy in the Treatment of Multiple Small Benign BreastNodulesZhu Wu, Zhuo Wang, Qingqing Ye, Rong Fan*Jingzhou First People's Hospital, Jingzhou 434000, China.Abstract: Objective: To observe the efficacy of different surgical protocols in the management of multiple benign breastnodules. Methods: Patients diagnosed with multiple benign breast nodules from 2021.4 to 2023.2 were divided into twogroups, blank and study groups, each with 51 cases, and treated with conventional open and ultrasound-guided minimallyinvasive rotational surgery respectively. Results: The study group had better incision diameter and VAS score at 24hpostoperatively than the blank group, with significant differences (P < 0.05). Regarding the postoperative complication rateindex, the study group vs. the blank group was 3.92% vs. 21.57% (P < 0.05). Conclusion: Minimally invasive spinotomyunder ultrasound guidance for the treatment of patients with multiple breast nodules is safe and effective and has thepotential to be used universally.Keywords: Small Benign Breast Nodules; Ultrasound Guidance; Minimally Invasive Rotational Surgery; OutcomeObservationIntroductionNipple discharge and breast tenderness are common symptoms of multiple breast nodules, and tumours are a commoncausative factor for this disease. Although conventional surgery can remove the entire nodule, the operation is invasive andconceals a variety of factors that can increase the risk of post-operative complications and is not conducive to rapid recovery.Minimally invasive spinotomy effectively compensates for the shortcomings of the traditional procedure by applying ahigh-speed form of spinotomy to fully aspirate the diseased tissue of the lesion and extract the specimen intact, with theadvantages of minimal trauma, minimal scarring and high precision [1]. In this paper, we compare the treatment of traditionalopen and minimally invasive spinotomy, and the medical records of 102 patients are extracted for the following analysis.1. Data and methods1.1 General informationThe 102 patients included in this study were diagnosed according to preoperative imaging and postoperativehistopathological examination, with clear indications for surgery, excluding those with pathological findings suggestingmalignant nodules and those who withdrew midway. The selected patients were divided equally into two groups of 51 caseseach, and the status of each group was as follows.Blank group: age 19~51 (32.41±2.19) years, duration of disease 6~25 (15.24±2.09) months, nodule diameter size0.5~2.3 (1.42±0.55) cm.-2- Advanced Emergency MedicineStudy group: Age 18-54 (3.52±2.26) years, duration of disease 7-26 (15.58±2.22) months, nodule diameter 0.4-2.5(1.55±0.61) cm.The above information was comparable between the two groups of patients (P > 0.05). This subject was carried out afterobtaining the approval of the ethics committee and the consent of the patients.1.2 MethodsTraditional open surgery was used in the blank group. The lesion was located with colour ultrasound before surgery, anda 2~3 ㎝ incision was made above the diseased breast to remove the entire lesion according to the specific number ofnodules to make the corresponding number of incisions. Traditional electrocoagulation was used to stop the bleeding, repairthe subcutaneous tissue, close the incision with conventional sutures, and apply pressure bandages and antibiotics for 7 daysafter surgery.The study group used minimally invasive spinotomy. The size, number and anatomical location of the nodules wereclarified by ultrasound exploration before surgery and the surgical incision was marked. After local anaesthesia, an incisionwas made within 2 ㎝ of the nodule and an attempt was made to remove multiple tumours with one incision, and inexceptional cases through two incisions. The ultrasound instrument guides the stabbing of the rotary cutter up to the deepposition of the nodule. The ultrasound image information is used with the rotary cutter system to effectively extract thebreast nodule and perform the operations such as excision and rotary cut, clear away all the accumulated blood, stop thebleeding by means of local pressure, and disinfect the puncture site in strict accordance with the protocol. A sterile dressingwas applied to treat the incision and the dressing was applied continuously for 5 to 7 d.1.3 Observation indicators(1) Surgery-related indicators: time spent on surgery, intraoperative blood loss, incision diameter, incision healing time,24-h postoperative visual analogue (VAS) score.(2) Post-operative complications.1.4 Statistical processingSPSS26.0 software processed the data, indicating surgery-related indicators, mean age, etc. The rate (%) indicated thecomplication rate, and X² was calculated. Test criteria: P < 0.05.2. Results2.1 Surgery-related indicatorsThe detection values of all surgery-related indexes in the patients of the study group were better than those of the blankgroup, and the data between the groups differed significantly and reached the level of significance (P < 0.05), Table 1.Table 1 Comparison of surgery-related indicators between groups of patients )( sxGroup（n）Surgerytime（min）Intraoperative blood loss（ml）Incisiondiameter（mm）Incisionhealing time（d）VAS at 24hpostoperatively（分）Research Group（51） 18.79±1.59 5.31±1.07 2.58±0.44 2.84±1.09 2.59±0.46Blank group（51） 33.06±5.17 12.11±1.59 27.14±6.04 4.69±1.34 4.22±1.01Volume 12 | Issue 1 -3-2.2 Postoperative complicationsThe incidence of postoperative complications in the study group was lower than that in the blank group, and thedifference was statistically significant (P < 0.05), as shown in Table 2.Table 2 Comparison of postoperative complication rates between groupsGroup（n）LocalhaematomaInfection Skin pigmentationBreastdeformityTotal occurrence（%）Research Group（51）0 1 1 0 2（3.92）Blank group（51）3 4 2 2 11（21.57）3. DiscussionBreast nodules are a common disease in the modern female population, most of them are benign, but a few are at risk ofcancer. It is generally believed that there is a correlation between female endocrine disorders and the development of thedisease, and that when the metabolism of progesterone and oestrogen is abnormally disturbed in the body, this can lead tobreast hyperplasia. Breast nodules have become a physical and psychological disease that can have a huge impact on thepatient's physical and mental state, inevitably reducing the quality of their daily life and work efficiency, and shouldtherefore be treated symptomatically as soon as possible after diagnosis [2].Currently, surgery is advocated for the treatment of multiple small breast nodules, but traditional open surgery, in whichinspection, separation and excision are carried out under direct vision, rarely causes damage to other breast tissues, but theincision made under this procedure is long and the operations performed during surgery can cause greater damage to thepatient. In this study, the time taken to perform the operation was less than one hour. In this study, the VAS scores foroperative time, intraoperative blood loss, incision diameter, incision healing time and 24h postoperative were (18.79±1.59)min, (5.31±1.07) ml, (2.58±0.44) mm, (2.84±1.09) d and (2.59±0.46) respectively, while the values for the above indicatorsin the blank group were in the order of ( (33.06±5.17) min, (12.11±1.59) ml, (27.14±6.04) mm, (4.69±1.34) d, (4.22±1.01)points, it is obvious that the patients in the study group had better treatment results. Minimally invasive spinotomy is ahollow-core biopsy tool that incorporates the principles of vacuum aspiration, electric cutting technology, the formerallowing complete excision of the pathological tissue, and the latter removing the focal tissue with the assistance of aspinotomy knife and an internal jacket needle. In the specific cutting session, a vacuum suction pump extracts thepathological tissue in real time and transports it outside the body. Multiple lesions can be removed quickly, efficiently andsafely using a single small incision under minimally invasive rotary incision [3]. Compared to traditional open surgery, theminimally invasive rotary incision is more discreet, has a smaller postoperative scar area, and has essentially no majorimpact on the appearance of the breast, gaining a high degree of certainty and acceptance among the patient population withbreast nodules.References[1] Liao H, Fang ZH, Chen LLL. Clinical study of minimally invasive spinotomy technique for the treatment ofmultiple small breast nodules [J]. China Medical Innovation,2019,16(18):111-114.[2] Tan BC. Clinical study of colour Doppler ultrasound to identify benign and malignant breast nodules[J]. Journal ofPractical Medical Technology, 2021, 28(07): 879-881.[3] Yang F, Yang QF. Effectiveness of ultrasound-guided minimally invasive spinotomy in the treatment of multiple-4- Advanced Emergency Medicinesmall benign breast nodules [J]. Journal of Contemporary Clinical Medicine, 2021, 34(02):32-33.Author Bio:First author.Name: Wu zhut (1982.5.14-), Male, Han Nationality, Place of Origin: Xiangtan, Hunan, Master, Title: AttendingPhysician, Unit: Jingzhou First People's Hospital, Department: Breast Surgery, Main Research Interests: Comprehensivetreatment of breast cancer, diagnosis and treatment of non-lactating mastitis, postoperative reconstruction of breast tumor.Corresponding author.Fan Rong (1980.1.10-), F, Han, Place of origin: Hubei. Jingzhou, Master, Title: Attending, Unit: Jingzhou First People'sHospital, Department: Department of Respiratory and Critical Care, Major research interests: chronic obstructive pulmonarydisease, interstitial lung disease, pulmonary embolism, pulmonary hypertension, ECMO life support, etc.Second author.Wang Zhuo (1968.10.10-), Male, Ethnicity: Han, Origin: Xiangyang City, Hubei Province, Highest Education: B.S.,Title: Deputy Chief Physician, Unit: Jingzhou First People's Hospital, Department: Breast Surgery, Main Research Interests:Comprehensive diagnosis and treatment of breast diseases and breast tumors, post-operative breast reconstruction, minimallyinvasive treatment of breast diseases, etc.Third author.Ye Qingqing (1979.2.23-), Female, Ethnicity: Han, Place of origin: Nanning, Guangxi, Highest education: Master, Title:Deputy Chief Physician, Unit: Jingzhou First People's Hospital, Department: Breast Surgery, Main research interests:standard treatment of breast tumours, surgical management of breast cancer.

Effectiveness of Ultrasound-Guided Minimally Invasive Spinotomy in the Treatment of Multiple Small Benign Breast Nodules

https://aem.usp-pl.com/index.php/aem/article/download/346/321

Effectiveness of Ultrasound-Guided Minimally Invasive Spinotomy in the Treatment of Multiple Small Benign Breast Nodules

Abstract

Similar works

Full text

Available Versions

Advanced Emergency Medicine (E-Journal)