Lim Geok-Hoon, Allen John Carson, Ng Ruey Pyng
Breast Department, KK Women's and Children's Hospital, Singapore, Republic of Singapore.
Duke-NUS Graduate Medical School, Singapore, Republic of Singapore.
Gland Surg. 2017 Aug;6(4):343-349. doi: 10.21037/gs.2017.03.06.
Although oncoplastic breast surgery is used to resect larger tumors with lower re-excision rates compared to standard wide local excision (sWLE), criticisms of oncoplastic surgery include a longer-albeit, well concealed-scar, longer operating time and hospital stay, and increased risk of complications. Round block technique has been reported to be very suitable for patients with relatively smaller breasts and minimal ptosis. We aim to determine if round block technique will result in operative parameters comparable with sWLE.
Breast cancer patients who underwent a round block procedure from 1st May 2014 to 31st January 2016 were included in the study. These patients were then matched for the type of axillary procedure, on a one to one basis, with breast cancer patients who had undergone sWLE from 1st August 2011 to 31st January 2016. The operative parameters between the 2 groups were compared.
22 patients were included in the study. Patient demographics and histologic parameters were similar in the 2 groups. No complications were reported in either group. The mean operating time was 122 and 114 minutes in the round block and sWLE groups, respectively (P=0.64). Length of stay was similar in the 2 groups (P=0.11). Round block patients had better cosmesis and lower re-excision rates. A higher rate of recurrence was observed in the sWLE group.
The round block technique has comparable operative parameters to sWLE with no evidence of increased complications. Lower re-excision rate and better cosmesis were observed in the round block patients suggesting that the round block technique is not only comparable in general, but may have advantages to sWLE in selected cases.
尽管肿瘤整形乳房手术与标准的广泛局部切除（sWLE）相比，用于切除更大的肿瘤且再次切除率更低，但对肿瘤整形手术的批评包括瘢痕更长（尽管隐蔽性好）、手术时间和住院时间更长以及并发症风险增加。据报道，圆形阻滞技术非常适合乳房相对较小且乳房下垂程度较轻的患者。我们旨在确定圆形阻滞技术是否会产生与sWLE相当的手术参数。
纳入2014年5月1日至2016年1月31日接受圆形阻滞手术的乳腺癌患者。然后将这些患者与2011年8月1日至2016年1月31日接受sWLE的乳腺癌患者按腋窝手术类型进行一对一匹配。比较两组之间的手术参数。
22例患者纳入研究。两组患者的人口统计学和组织学参数相似。两组均未报告并发症。圆形阻滞组和sWLE组的平均手术时间分别为122分钟和114分钟（P = 0.64）。两组的住院时间相似（P = 0.11）。圆形阻滞组患者的美容效果更好，再次切除率更低。sWLE组观察到更高的复发率。
圆形阻滞技术具有与sWLE相当的手术参数，且无并发症增加的证据。圆形阻滞组患者的再次切除率更低，美容效果更好，这表明圆形阻滞技术不仅总体上具有可比性，而且在某些情况下可能比sWLE具有优势。
