Fukuma Eisuke
Breast Center, Kameda Medical Center.
Nihon Geka Gakkai Zasshi. 2006 Mar;107(2):64-8.
Since 1995, endoscopic breast surgery (EBS) has been gradually established in Japan. Establishment of EBS was inextricably linked to explosive development of instruments for endoscopic surgery and profound theoretical understanding, how to perform broad & stable dissection of the compact connective tissue thorough small incisions. EBS consisted chiefly of two procedures added to breast and axilla and procedures to breast is classified into three methods according to incisions, axillar, periareolar and combined incisions. With EBS technique, any kind breast surgery, sentinel node biopsy, reconstruction, augmentation, and benign tumor excision, could be performed through same skin incisions. Curability of breast cancer EBS is same as that with conventional method and local recurrence rate after total and partial mastectomy. All breast cancer without skin involvement of cancer would be candidate for EBS. To minimize invasiveness of treatment and maintain cosmetic outcome of breast, combination treatment of ablation treatment, EBS and evolution of radiation therapy would be important.
自1995年以来,内镜下乳腺手术(EBS)在日本已逐渐确立。EBS的确立与内镜手术器械的迅猛发展以及深入的理论理解紧密相关,即如何通过小切口对致密结缔组织进行广泛且稳定的解剖。EBS主要包括在乳房和腋窝增加的两种手术方法,乳房手术根据切口可分为三种方法,即腋窝切口、乳晕周围切口和联合切口。采用EBS技术,任何类型的乳腺手术,如前哨淋巴结活检、重建、隆乳和良性肿瘤切除,都可通过相同的皮肤切口进行。EBS治疗乳腺癌的治愈率与传统方法相同,全乳切除和部分乳房切除后的局部复发率也相同。所有未累及皮肤的乳腺癌均适合EBS。为了使治疗的侵入性最小化并保持乳房的美容效果,消融治疗、EBS与放射治疗进展的联合治疗将非常重要。