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肿瘤整形乳房手术与传统保乳手术的比较性回顾研究

Oncoplastic breast surgery versus conventional breast-conserving surgery: a comparative retrospective study.

作者信息

Behluli Ilmi, Le Renard Pol-Edern, Rozwag Kamila, Oppelt Peter, Kaufmann Andreas, Schneider Achim

机构信息

Department of Gynaecology and Gynaecological Oncology, Charité University Medicine Berlin, Berlin, Germany.

Department of Gynaecology, Kantonsspital Baselland, Liestal, Switzerland.

出版信息

ANZ J Surg. 2019 Oct;89(10):1236-1241. doi: 10.1111/ans.15245. Epub 2019 Apr 16.

Abstract

BACKGROUND

In addition to conventional breast-conserving surgery (BCS), oncoplastic breast surgery (OBS) is an operation technique that strives simultaneously to increase oncological safety and patient's satisfaction. It is the combination of the best-proven techniques in plastic surgery with surgery for breast cancer. In a growing number of indications, OBS overcomes the limit of conventional BCS by allowing larger resection volumes while avoiding deformities. The aim of our retrospective study (2012-2014) was to compare oncological outcomes of OBS versus BCS.

METHODS

We compared two groups of patients with primary non-metastatic breast tumours: group A (n = 291), where BCS was performed, versus group B (n = 52), where OBS was performed. Surgical interventions were performed in German and Swiss teaching hospital settings. The surgeon for group B had subspecialist training in OBS. We assessed outcome in term of re-excision rates, resection margin and complications.

RESULTS

Groups were homogenous (no significant differences in terms of age, tumour size, tumour type or grade). The resection margin was larger in group B (7 mm) than in group A (3 mm). Re-excision rate of group B (8%) was significantly lower than in group A (31%). Complication rates were comparably low in groups A and B.

CONCLUSION

Despite the limits of retrospective design, our study confirms that OBS is safe and reduces the re-excision rates and the need for further surgery. OBS has the potential to improve oncological care and should be more widely adopted.

摘要

背景

除了传统保乳手术(BCS)外,肿瘤整形乳房手术(OBS)是一种旨在同时提高肿瘤学安全性和患者满意度的手术技术。它是整形外科中经过充分验证的技术与乳腺癌手术的结合。在越来越多的适应症中,OBS通过允许更大的切除体积同时避免畸形,克服了传统BCS的局限性。我们这项回顾性研究(2012 - 2014年)的目的是比较OBS与BCS的肿瘤学结果。

方法

我们比较了两组原发性非转移性乳腺肿瘤患者:A组(n = 291),接受BCS手术;B组(n = 52),接受OBS手术。手术干预在德国和瑞士的教学医院环境中进行。B组的外科医生接受过OBS亚专业培训。我们从再次切除率、切缘和并发症方面评估结果。

结果

两组具有同质性(在年龄、肿瘤大小、肿瘤类型或分级方面无显著差异)。B组的切缘(7毫米)比A组(3毫米)更大。B组的再次切除率(8%)显著低于A组(31%)。A组和B组的并发症发生率相对较低。

结论

尽管回顾性设计存在局限性,但我们的研究证实OBS是安全的,可降低再次切除率和进一步手术的需求。OBS有改善肿瘤治疗的潜力,应更广泛地采用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aea0/6849881/88966f09efd6/ANS-89-1236-g001.jpg

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