乳腺良性腫瘍に対する内視鏡下腫瘍摘出術

Endoscopic Tumor Extirpation for Benign Breast Diseases

　教室では，1997年より乳腺の良性腫瘍を対象に，細径内視鏡とその関連器材を用いて，乳房外においた最大12mmの小切開からの腫瘍摘出術を考案し，積極的に臨床応用している．今回，その手術手技，治療成績について述べた．20例の平均年齢は23.5歳，全例良性で最大腫瘍径は4.4cm,2例（9.5％）が両側性，3例（14.3％）が多発性であった．初期の2例を乳房下溝線から行った以外はすべて中腋窩線からのアプローチで行っている．本術式は，従来の局麻下生検と比較してもまったく根治度を損なうことなく，乳房自体に傷を付けないまま腋窩の小切開から腫瘍を摘出し得るコスメトロジーを追求した新術式であると考えられる．

Endoscopic extirpation using a fine endoscope and related needle device via extra-mammary approach has been applied for benign breast tumors since 1997 in the 2nd Department of Surgery, Kyushu University. Operative procedures, morbidity and mortality are herein presented. There were 20 patients (21 tumors) with a mean age of 23.5 years old, whose tumor had been diagnosed as benign, and the average diameter was 4.4 cm. Three patients have a multiplicity including 2 with bilateral lesions. The transaxillary approach was chosed in 18 patients, and two patients were operated via the inframammary line.