Effect And Learning Curve Analysis Of Vacuum-assisted Minimally Invasive Rotary Biopsy System In The Treatment Of Benign Breast Masses

Objective:To investigate the curative effect and learning curve of ultrasound guided Vacuum assisted biopsy(VAB)in the treatment of benign breast mass.Methods:Part Ⅰ:Comparing the efficacy of vacuum-assisted rotary biopsy system and traditional surgery in the treatment of benign breast masses:A non-randomized controlled trial was used to select 118 patients with benign breast masses who underwent breast surgery in Pingdu Maternal and Child Health Hospital from January 2019 to August 2021 as the research objects,and were divided into experimental group(61 cases)and control group(57 cases)according to the patients’ wishes.The experimental group underwent ultrasound-guided vacuum-assisted minimally invasive circumferential surgery,while the control group underwent traditional open surgery.All surgical and postoperative follow-up data of the patients were collected,and the surgical results of the two groups were compared,including postoperative complications,residual rates and patient satisfaction.Part Ⅱ:Learning curve analysis of vacuum-assisted rotary biopsy system in the treatment of benign breast masses:This study is a prospective study.61 patients with benign breast tumors requiring minimally invasive treatment admitted to the Breast Surgery Department of Pingdu Maternal and Child Health Hospital from January 2019 to August 2021 were selected and operated by the same young physician.CUSUM method was used to analyze the calculation of learning curve,so as to obtain the inflection point of VAB learning curve.It was divided into two stages:learning improvement and mastering.Then,the baseline data,surgical conditions,postoperative pain scores at different times,postoperative satisfaction,postoperative complications and residual rate of the two stages were compared to analyze the learning curve of vacuum-assisted circumflex system for the treatment of benign breast tumors.Results:Part Ⅰ:(1)There was no significant difference in age,mass diameter and lesion site between the VAB group and the traditional open surgery group(P>0.05).(2)In the VAB group,the operation time was short,the incision was small,and the intraoperative blood loss was small,the differences were statistically significant(P<0.05).(3)The pain scores of the VAB group and the traditional open surgery group were different at different time after surgery,and the pain scores gradually decreased,with statistical significance(P<0.05).The pain score of VAB group was lower than that of traditional open surgery group at different time,and the difference was statistically significant(P<0.05).(4)The total postoperative satisfaction of patients in VAB group was significantly higher than that in open group,and the difference was statistically significant(P<0.05).(5)The incision infection rate,skin ecchymosis rate and postoperative breast deformation rate in the VAB group were significantly lower than those in the open surgery group,with statistical significance(P<0.05).There was no statistical significance between the VAB group and the traditional open surgery group in intra-breast hematoma and the residual rate evaluated by color ultrasound 3 months after surgery(P>0.05).Part Ⅱ:(1)CUSUM analysis was used to fit the operative time of the patients.After the treatment of benign breast tumors with vacuum-assisted rotary resection system,the operative time tended to be stable after the completion of 24 cases.With 24 cases as the boundary,the patients were divided into learning and improving stage(24 cases)and mastering stage(37 cases).(2)The operative time and intraoperative blood loss in the proficiency stage group were significantly lower than those in the learning improvement stage group,with statistical significance(P<0.05),while the incision length had no significant difference(P>0.05).(3)The pain score of the proficiency stage group at different times was lower than that of the learning improvement stage group,and the difference was statistically significant(P<0.05).(4)The total satisfaction of patients in the proficiency stage was significantly higher than that in the learning improvement stage,and the difference was statistically significant(P<0.05).(5)The incidence of postoperative complications in the proficiency stage group was significantly lower than that in the learning improvement stage group,with statistical significance(P<0.05),but there was no significant difference in the residual rate between the two groups(P>0.05).Conclusion:Vacuum assisted rotary excision system can be used to treat benign breast tumors with short operation time,small incision,less blood loss,quick healing,timely relief of postoperative pain,good cosmetic effect and high patient satisfaction,which accords with the concept of accelerated surgical rehabilitation and is worth further popularizing and applying in clinic,and 24 cases can be mastered by.