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一种用于乳腺癌的内镜下保留乳头乳房切除术技术。

A Technique of Endoscopic Nipple-Sparing Mastectomy for Breast Cancer.

作者信息

Wang Yu, Wu Ji-Xiang, Guan Shan

机构信息

Department of Oncology.

Department of General Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

JSLS. 2017 Apr-Jun;21(2). doi: 10.4293/JSLS.2017.00028.

Abstract

BACKGROUND AND OBJECTIVES

Nipple-sparing mastectomy (NSM) is a widely accepted surgical technique for patients with early breast cancer. The technique improves cosmetic outcomes, but a decrease in nipple sensitivity has been observed with NSM because of the incision into the nipple-areola complex (NAC). Endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) removes all breast tissue through the axillary incision used for the sentinel lymph node biopsy, to avoid incision around the NAC area. With only one incision, NAC sensitivity is less likely to be affected by this technique. We sought to investigate the effect of ENSMSLS on sensation in the NAC, compared with NSM.

METHODS

A single-institution retrospective review was performed from August 2014 through August 2015. Thirty patients who underwent NSM in the past 6 years were frequency matched for age and cancer stage with those who underwent ENSMSLS between 2014 and 2015. All patients were recalled and re-examined for the study. Patients from the ENSMSLS group were recalled twice at both 3 and 6 months after surgery. Matched control subjects who underwent NSM were examined when they were recalled. The sensations of pressure, temperature, and vibration were measured.

RESULTS

Patients who underwent ENSMSLS were significantly less likely to have decreased or impaired sensations of pressure, temperature, and vibration compared those who had NSM. The improvement in preservation of sensations by the use of ENSMSLS was very impressive.

CONCLUSIONS

ENSMSLS, which avoids incision around the NAC, significantly decreases the possibility of decline in NAC sensation.

摘要

背景与目的

保留乳头的乳房切除术(NSM)是早期乳腺癌患者广泛接受的手术技术。该技术改善了美容效果,但由于乳头乳晕复合体(NAC)切口的原因,NSM术后观察到乳头敏感性下降。带皮肤提升系统的内镜保留乳头乳房切除术(ENSMSLS)通过用于前哨淋巴结活检的腋窝切口切除所有乳腺组织,以避免在NAC区域周围切口。仅通过一个切口,该技术对NAC敏感性的影响较小。我们试图研究与NSM相比,ENSMSLS对NAC感觉的影响。

方法

对2014年8月至2015年8月进行单机构回顾性研究。将过去6年接受NSM的30例患者按年龄和癌症分期与2014年至2015年接受ENSMSLS的患者进行频率匹配。所有患者均被召回并重新检查以进行研究。ENSMSLS组的患者在术后3个月和6个月被召回两次。接受NSM的匹配对照受试者在被召回时进行检查。测量压力、温度和振动感觉。

结果

与接受NSM的患者相比,接受ENSMSLS的患者压力、温度和振动感觉下降或受损的可能性显著降低。使用ENSMSLS在感觉保留方面的改善非常显著。

结论

避免在NAC周围切口的ENSMSLS显著降低了NAC感觉下降的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/5482913/b4ac0a807758/jls0201636360001.jpg

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