非溶脂CO₂充气法经腋窝入路单孔腔镜技术治疗男性乳房发育的临床治疗

Clinical Treatment of Gynecomastia Using Non-Lipolytic CO₂ Insufflation via Transaxillary Single-Port Endoscopic Technique

摘要: 目的：本次研究旨在讨论非溶脂CO₂充气法经腋窝入路单孔腔镜技术在治疗男性乳房发育期间的应用效果。方法：本次研究随机纳入2023年1至2024年1月由我院收治的男性乳房发育症患者作为受试者，总计37例，每位患者两侧乳房随机接受不同手术方式分为实验侧(n = 37)与对照侧(n = 37)，实验侧采用非溶脂CO₂充气法经腋窝入路单孔腔镜，对照组接受溶脂法乳腔镜腋窝入路手术治疗，对比两组患者临床治疗效果、手术相关指标、术后美容满意度以及心理状况。结果：患者对两侧乳房行外形评价，实验侧乳房外形评价优于对照侧，差异有统计学意义(P < 0.05)；实验侧拔管时长较对照侧延长，组间数据差异显著(P < 0.05)，手术时间与手术出血量相较于对照组更低；实验侧术后美容满意度相较于对照侧更高，组间数据差异显著(P < 0.05)；心理状况评分与对照组差异不显著(P > 0.05)。结论：为男性乳房发育症患者提供非溶脂CO₂充气法经腋窝入路单孔腔镜技术治疗，可以有效缩减手术时长，改善治疗效果，减少术中出血量，提高患者对术后美容效果的满意度。

Abstract: Objective: This study aims to investigate the efficacy of the non-liposuction CO₂ insufflation method via a single-port transaxillary endoscopic approach in the treatment of gynecomastia. Methods: A total of 37 patients with gynecomastia admitted to our hospital from January 2023 to January 2024 were randomly enrolled. Each patient underwent two different surgical techniques on bilateral breasts: the experimental side (n = 37) was treated with the non-liposuction CO₂ insufflation single-port transaxillary endoscopic technique, while the control side (n = 37) received the liposuction-assisted endoscopic transaxillary approach. Clinical outcomes, operative parameters, postoperative cosmetic satisfaction, and psychological status were compared between the two groups. Results: The experimental side demonstrated superior breast contour evaluation compared to the control side, with a statistically significant difference (P < 0.05). The extubation time was significantly longer in the experimental side (P < 0.05), while operative duration and intraoperative blood loss were significantly reduced compared to the control group. Postoperative cosmetic satisfaction was significantly higher in the experimental side (P < 0.05), though no significant difference was observed in psychological status scores between the two groups (P > 0.05). Conclusion: The non-liposuction CO₂ insufflation single-port transaxillary endoscopic technique effectively shortens operative time, improves therapeutic outcomes, reduces intraoperative bleeding, and enhances patient satisfaction with postoperative cosmetic results in the treatment of gynecomastia.