Velazco Cristine S, Wasif Nabil, Pockaj Barbara A, Gray Richard J
Division of Surgical Oncology, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
Am J Surg. 2017 Dec;214(6):1091-1093. doi: 10.1016/j.amjsurg.2017.08.025. Epub 2017 Sep 19.
Radioactive seed localization (RSL) is an alternative to wire localization. We compared the rate of positive margins for evidence of a learning curve in implementing RSL.
A retrospective review of RSL by three surgeons at a single institution from 2002 to 2016. Positive margins were defined as ink on tumor.
Surgeon experience with RSL for ranged from 142 to >500 cases. The positive margin rate among the first 100 of each surgeons' experience (n = 300) was 2.3% and the rate during the most recent up to 100 cases after experience with at least 100 RSL procedures (n = 242) was 4.1% (p = 0.32). Individual surgeon's positive margin rates ranged from 2 to 5% in the early experience and 2-7% in the later experience (p = NS).
RSL for breast conservation surgery has a low rate of positive margins even early in a surgeon's experience. Implementation of RSL can be done with no evidence of a learning curve.
放射性种子定位（RSL）是金属丝定位的一种替代方法。我们比较了切缘阳性率，以寻找实施RSL过程中学习曲线的证据。
对一家机构的三位外科医生在2002年至2016年期间进行的RSL进行回顾性研究。切缘阳性定义为肿瘤上有墨水标记。
外科医生的RSL经验范围为142至超过500例。每位外科医生最初100例手术（n = 300）中的切缘阳性率为2.3%，在至少进行100例RSL手术后的最近100例手术期间（n = 242），切缘阳性率为4.1%（p = 0.32）。个别外科医生在早期经验中的切缘阳性率为2%至5%，在后期经验中为2%至7%（p = 无统计学意义）。
即使在外科医生经验早期，用于保乳手术的RSL切缘阳性率也很低。实施RSL时没有学习曲线的证据。
