Lee Jeea, Park Hyung Seok, Lee Haemin, Lee Dong Won, Song Seung Yong, Lew Dae Hyun, Kim Jee Ye, Park Seho, Kim Seung Il
Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Front Oncol. 2021 Jan 8;10:594388. doi: 10.3389/fonc.2020.594388. eCollection 2020.
This study is to directly compare surgical outcomes between conventional nipple-sparing mastectomy (CNSM) and robot-assisted nipple-sparing mastectomy (RNSM).
For this case-control study, 369 cases of 333 patients who underwent CNSM or RNSM with immediate reconstruction between November 2016 and January 2019 at Severance Hospital in Seoul, Republic of Korea were reviewed. Patients with stage IV breast cancer (n = 1), receiving neoadjuvant chemotherapy (n = 43), or subjected to previous operations (n = 14) or radiotherapy on the breasts were excluded. The main outcomes were comparing rates of post-operative complications, of high-grade post-operative complications as defined by the Clavien-Dindo classification, and nipple necrosis between the CNSM and the RNSM groups.
A total of 311 cases, including 270 CNSMs and 41 RNSMs, were analyzed. The rates of post-operative nipple necrosis ( = 0.026, 2.4 15.2%) and of high-grade post-operative complications ( = 0.031, 34.8 17.1%) in the RNSM group were significantly lower than those in the CNSM group.
RNSM was associated with lower rates of high-grade post-operative complications and nipple necrosis than CNSM for patients with small breast volumes and less ptotic breasts.
本研究旨在直接比较传统保乳乳房切除术（CNSM）和机器人辅助保乳乳房切除术（RNSM）的手术效果。
在这项病例对照研究中，回顾了2016年11月至2019年1月期间在韩国首尔Severance医院接受CNSM或RNSM并立即进行重建手术的333例患者的369例病例。排除IV期乳腺癌患者（n = 1）、接受新辅助化疗的患者（n = 43）、曾接受过乳房手术的患者（n = 14）或接受过乳房放疗的患者。主要观察指标是比较CNSM组和RNSM组之间的术后并发症发生率、根据Clavien-Dindo分类定义的严重术后并发症发生率以及乳头坏死率。
共分析了311例病例，其中包括270例CNSM和41例RNSM。RNSM组的术后乳头坏死率（P = 0.026，2.4%对15.2%）和严重术后并发症发生率（P = 0.031，34.8%对17.1%）均显著低于CNSM组。
对于乳房体积较小且乳房下垂程度较轻的患者，RNSM与CNSM相比，严重术后并发症和乳头坏死的发生率较低。
