Endoscopy & Oncoplastic Breast Surgery Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Ann Surg Oncol. 2018 May;25(5):1340-1349. doi: 10.1245/s10434-018-6383-z. Epub 2018 Feb 26.
A new hybrid technique for single-axillary-incision endoscopic-assisted nipple-sparing mastectomy (E-NSM) was introduced. Preliminary results are reported.
Patients who received single-axillary-incision E-NSM from August 2013 to August 2017 were searched from a single institution. Data were analyzed to determine the effectiveness and oncologic safety of single-axillary-incision E-NSM. Patient-oriented cosmetic outcome report was also obtained.
During the study period, a total of 50 E-NSM with single-incision procedures were performed in 41 female patients with breast cancer, including 11 (26.8%) patients with bilateral disease. Their mean age was 45.3 ± 8.4 years. The mean size of tumors encountered during the 50 single-incision E-NSM procedures was 2.3 ± 1.8 (0.1-7.3) cm for invasive tumors and 2.6 ± 1.7 (0.2-5.7) cm for carcinoma in situ lesions. Six (12%) of those tumors were multifocal/multicentric. Lymph node metastasis was found during 12% of the procedures. Forty-five (90%) received immediate breast reconstruction with gel implant. Mean operating time was 244.3 ± 82.8 min. The overall complication rate was 6%, and no total nipple necrosis or implant loss was observed. No locoregional recurrence or distant metastasis was found during mean follow-up of 21.6 months. About 94.4% of patients were satisfied with the postoperative scar location and wound length. All patients who responded would choose the same operation again.
The proposed single-axillary-incision endoscopic hybrid technique for nipple-sparing mastectomy was a safe procedure with low morbidity and associated with high patient satisfaction.
介绍了一种新的单腋窝切口内镜辅助保乳头乳房切除术（E-NSM）的杂交技术。报告了初步结果。
从一家医疗机构中搜索了 2013 年 8 月至 2017 年 8 月接受单腋窝切口 E-NSM 的患者。分析数据以确定单腋窝切口 E-NSM 的有效性和肿瘤安全性。还获得了患者导向的美容结果报告。
在研究期间，对 41 例患有乳腺癌的女性患者进行了 50 例单切口 E-NSM 手术，其中 11 例（26.8%）患者患有双侧疾病。她们的平均年龄为 45.3±8.4 岁。在 50 例单切口 E-NSM 手术中，肿瘤的平均大小为浸润性肿瘤为 2.3±1.8（0.1-7.3）cm，原位癌病变为 2.6±1.7（0.2-5.7）cm。其中 6 例（12%）肿瘤为多灶/多中心。在 12%的手术中发现淋巴结转移。45 例（90%）接受了凝胶植入物的即刻乳房重建。平均手术时间为 244.3±82.8 分钟。总并发症发生率为 6%，未观察到总乳头坏死或植入物丢失。在平均 21.6 个月的随访中未发现局部复发或远处转移。约 94.4%的患者对术后瘢痕位置和伤口长度满意。所有有反应的患者都会再次选择相同的手术。
提出的单腋窝切口内镜辅助保乳头乳房切除术是一种安全的手术，发病率低，患者满意度高。
