浅在筋膜深葉を剥離の指標とした内視鏡下良性乳腺腫瘍の1摘出例

A Case of Benign Breast Tumor Treated by Video-assisted Surgery with the Approach Through the Layer Underneath the Deep Layer of Superficial Fascia

　内視鏡下良性乳腺腫瘍摘出術は，美容的に優れた術式であると同時に手術侵襲が小さく，手技が容易で，安全に行えることも重要である．われわれは23歳の女性，線維腺腫の症例に対し内視鏡下手術を施行した．その際，乳腺実質後面の浅在筋膜深葉を指標とし，乳腺後隙で浅在筋膜深葉のすぐ後面の剥離層より腫瘍に到達した．この到達経路は剥離が容易で，出血も少なく簡便に術野の確保が可能であった．手術時間は120分，出血量は5mlであった．術前検査にて，腫瘍が乳腺実質後面に存在する場合，この到達経路は侵襲も小さく有用であると思われた．

While video-assisted surgery is beneficial to benign tumors of the breast because of its cosmetic advantage, it must be performed with safety. easiness and less invasiveness. We report a new approach to the lesion through the retromammary space. A 23 year-old woman with fibroadenoma of the breast underwent video-as-sisted resection of the tumor. During this operation, the access was obtained through the layer underneath the deep layer of the superficial fascia. The operating time was 120min with 5ml of blood loss. This approach is fea-sible and is advisable to the tumor located in the posterior portion of the mammary gland.