Single-port three-dimensional (3D) endoscopic-assisted breast surgery—preliminary results and patient-reported satisfaction in 145 breast cancer and gynecomastia cases

World Journal of Surgical Oncology

Research

Hsin-I. Huang¹  Clement Luck Khng Chia²  Korawan Chandrachamnong³  Dar-Ren Chen⁴  Shou-Tung Chen⁴  Hung-Wen Lai⁵  Chayanee Sae-lim⁶ 

[1] Department of Information Management, National Sun-Yat-Sen University, Kaohsiung, Taiwan;Department of Surgery, Breast Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore;Department of Surgery, Division of Breast Surgery, Police General Hospital, Bangkok, Thailand;Department of Surgery, Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan;Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;Department of Surgery, Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, 500, Changhua, Taiwan;Department of Surgery, Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan;Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;Minimal Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan;Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Breast Surgery, Yuanlin Christian Hospital, Yuanlin, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;

关键词: Endoscopic-assisted breast surgery (EABS);    Single-port 3-dimensional (3D) endoscopic-assisted breast surgery;    Nipple-sparing mastectomy (NSM);    Breast-conserving surgery (BCS);    Breast cancer;    Endoscopic gynecomastia surgery;    Robotic nipple-sparing mastectomy (R-NSM);   

DOI  :  10.1186/s12957-023-03191-7

 received in 2023-06-13, accepted in 2023-09-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMinimal-accessed (robotic and endoscopic) breast cancer surgery is increasingly performed due to better cosmetic results and acceptable oncological outcomes. This study aims to demonstrate the clinical safety and patient-reported cosmetic satisfaction of single-port three-dimensional endoscopic-assisted breast surgery (S-P 3D EABS), which is our new endoscopic surgical innovation, in both malignant and benign breast conditions.MethodsPatients who underwent S-P 3D EABS from 1 August 2018 to 31 July 2022 in a single institution were enrolled. Clinical outcomes of this procedure were retrospectively reviewed, and the patient-reported cosmetic satisfaction was evaluated by a questionnaire and reported herein.ResultsDuring the study period, 145 patients underwent 164 procedures of S-P 3D EABS. One hundred fifty (91.5%) procedures were endoscopic-assisted nipple-sparing mastectomy (S-P 3D E-NSM; 117 therapeutic procedures for breast cancer, 13 prophylactic mastectomies, 20 procedures for gynecomastia). Fourteen (8.5%) procedures of endoscopic-assisted breast-conserving surgery (S-P 3D E-BCS) were performed (12 S-P 3D E-BCS, 2 S-P 3D E-BCS with 3D videoscope-assisted partial breast reconstruction, which was 1 case of latissimus dorsi flap and 1 case of omental flap). The mean operative time was 245 ± 110 min in S-P 3D E-NSM and 260 ± 142 min in S-P 3D E-BCS. The mean intraoperative blood loss was 49.7 ± 46.9 ml in S-P 3D E-NSM and 32.8 ± 17.5 ml in S-P 3D E-BCS. Subnipple biopsy showed positive malignancy in 3 (2.6%) S-P 3D E-NSM patients. None of the S-P 3D E-BCS patients found margin involvement; however, 3 (2.6%) reported margin involvement in S-P 3D E-NSM patients. Thirty-two complications were found (24.6%): 7 (5.3%) transient nipple-areolar complex (NAC) ischemia, 7 (5.3%) partial NAC necrosis, 1 (0.7%) total NAC necrosis, and 1 (0.7%) implant loss. During the mean follow-up time of 34 months, there were 2 (1.5%) patients with locoregional recurrence, 9 (6.9%) distant metastasis, and 2 (1.5%) mortality. 78.6% (77/98) of patients answering the cosmetic-evaluated questionnaire reported good and excellent overall satisfaction.ConclusionsS-P 3D EABS is a novel surgical innovation, which is able to perform safely in either malignant or benign breast conditions and offer promising cosmetic results.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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