Endoscopy-assisted surgery for the management of benign breast tumors: technique, learning curve, and patient-reported outcome from preliminary 323 procedures

World Journal of Surgical Oncology

Technical Innovations

Hui-Yu Lin¹  Shu-Ling Chen²  Shou-Tung Chen³  Shou-Jen Kuo³  Dar-Ren Chen³  Hung-Wen Lai⁴ 

[1] Division of Breast surgery and General Surgery, Department of Surgery, Cardinal Tien Hospital, Xindian Dist., New Taipei City, Taiwan;Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, 500, Changhua, Taiwan;Department of Surgery, Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, 500, Changhua, Taiwan;Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan;Department of Surgery, Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, 500, Changhua, Taiwan;Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan;Department of Surgery, Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;School of Medicine, National Yang Ming University, Taipei, Taiwan;

关键词: Endoscopy-assisted breast surgery (EABS);    Minimally invasive breast surgery;    Benign breast lesions;   

DOI  :  10.1186/s12957-016-1080-5

 received in 2016-08-12, accepted in 2016-12-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundEndoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors. In this study, we report the preliminary results of 323 EABS procedures performed at our institution for the management of benign breast tumors.MethodsThe medical records of patients who underwent EABS for benign breast lesions during the periods August 2010 to December 2015 were collected from the Changhua Christian Hospital EABS database. Data on clinicopathologic characteristics, type of surgery, hospital stay, and complications were analyzed to determine the effectiveness of the procedure for benign breast tumors. The operating time with the number of procedure performed was analyzed for learning curve evaluation. Patient satisfaction with cosmetic outcome was evaluated with a self-report questionnaire.ResultsA total of 323 EABS procedures were performed in 286 patients with benign breast lesions, including 249 (90.5%) patients with unilateral lesions. The mean age was 36 years, the mean tumor size was 2.2 cm, and the mean distance from the nipple to the tumor was 5.2 cm. Most (93.8%, 303/323) of these tumors were excised through a transareolar wound, 2.4% (8/323) through an axillary wound, and 0.3% (1/323) through the infra-mammary fold. Histopathologic analysis revealed that 63.5% (202/318) of the tumors were fibroadenoma-related lesions. The mean operative time was 81.4 min (59~89 min), which was decreased with experience increased. The overall rate of complications was 6.5%, and all were minor and wound-related. Among the 110 patients who participated in the self-report cosmetic outcome evaluation, 85.4% reported being satisfied with the cosmetic result, and almost all were satisfied with breast symmetry. Of the patients interviewed, 92.7% reported that they would choose the same procedure if they had to undergo the operation again.ConclusionsOur preliminary results show that transareolar video-assisted breast surgery is a safe and effective procedure with good cosmetic outcome and that it could be appropriate for patients with moderate to large peripherally located breast tumors.Trial registrationCCH-IRB No.15115. Registered 14 December 2015 (retrospectively registered).

【 授权许可】

CC BY   
© The Author(s). 2017