Saimura Michiyo, Mitsuyama Shoshu, Anan Keisei, Koga Kenichiro, Watanabe Masato, Ono Minoru, Toyoshima Satoshi
Department of Surgery, Kitakyushu Municipal Medical Center, Fukuoka, Japan.
Asian J Endosc Surg. 2013 Aug;6(3):203-8. doi: 10.1111/ases.12018. Epub 2013 Feb 1.
Endoscopic surgery is reportedly associated with smaller scars and greater patient satisfaction. Herein we evaluate the early results of endoscopy-assisted breast-conserving surgery(E-BCS).
Between May 2009 and October 2010, 61 women with breast cancer underwent E-BCS. We performed E-BCS on patients with tumors measuring less than 2 cm, without skin or pectoralis muscles invasion. Any patients with microcalcified lesions or axillary lymph node metastasis were excluded. We used an endoscopic vein retractor to dissect the dorsal layer of the mammary gland from a small axillar incision. We dissected the subcutaneous layer and cut the mammary gland vertically from a periareolar incision. We evaluated the clinicopathological characteristics, the surgical outcomes, and early cosmetic results.
The mean age of the patients was 58.5 years, and the mean tumor size was 1.4 cm. Sentinel node biopsy was positive in seven patients, all of whom underwent axillary node dissection. An additional intraoperative resection of the breast was performed in 12 patients. The mean length of the operation was 167 min, and the mean blood loss was 27 mL. Eight patients received a boost to the tumor bed. The cosmetic results were satisfactory, and the wound scar was inconspicuous in most patients.
Herein we demonstrate that E-BCS is a feasible and safe procedure for patients with early breast cancer. It allows for a better cosmetic scar location and offers patients favorable aesthetic results in the short-term follow-up results.
据报道，内镜手术的疤痕较小，患者满意度更高。在此，我们评估内镜辅助保乳手术（E-BCS）的早期结果。
2009年5月至2010年10月期间，61例乳腺癌女性接受了E-BCS。我们对肿瘤直径小于2厘米、未侵犯皮肤或胸肌的患者进行E-BCS。排除任何有微钙化病变或腋窝淋巴结转移的患者。我们使用内镜静脉牵开器从小腋窝切口分离乳腺的背层。我们从乳晕周围切口分离皮下层并垂直切开乳腺。我们评估了临床病理特征、手术结果和早期美容效果。
患者的平均年龄为58.5岁，平均肿瘤大小为1.4厘米。7例患者前哨淋巴结活检呈阳性，均接受了腋窝淋巴结清扫术。12例患者术中额外进行了乳房切除术。平均手术时间为167分钟，平均失血量为27毫升。8例患者接受了瘤床补量照射。美容效果令人满意，大多数患者的伤口疤痕不明显。
在此我们证明，E-BCS对于早期乳腺癌患者是一种可行且安全的手术方法。它能实现更好的美容疤痕位置，并在短期随访结果中为患者提供良好的美学效果。
