目的探讨乳腔镜手术治疗男性乳腺发育症的手术方法和安全性问题。 方法对我院自2010年2月至2011年3月期间收治的11例男性乳腺发育症患者用乳腔镜行单纯皮下腺体切除术。 结果11例手术均获成功，术后3～6 d拔除引流管，术后平均住院时间12.5 d； 术后发生皮下气肿3例，乳头部浅层缺血3例，无其他并发症。 结论乳腔镜手术治疗男性乳腺发育症能达到常规手术无法取得的美容效果，且较为安全。乳腔镜应用前景广阔。
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.