Chirurgia (Bucur). 2021 Mar-Apr;116(2):135-142. doi: 10.21614/chirurgia.116.2.135.
Bachground: Robotic breast surgery is an emergent procedure with encouraging preliminary results. The aim of this study is to assess the feasibility and the safety of robotic nipple sparing mastectomy (RNSM) with immediate prosthetic breast reconstruction (IPBR). This is a prospective study including from December 2015 to January 2020 all RNSM surgeries with IPBR, in patients with moderate ptosis and A B or C cup. The primary endpoint was the rate of major necrosis. Secondary endpoints were conversion rate, postoperative complications (infections, hematoma, implant exposure), aesthetic results and quality of life. 79 patients underwent 138 RNSM with IPBR. The average follow-up was 28 months. 2 procedures required conversion. Two cases of major necrosis occurred (1.4%). 9 surgical site infections were observed (6.5%), 4 infections could be treated with implant replacement. Unfortunately, 5 others resulted in implant loss. 4 other implant losses occurred: 2 due to major necrosis, and 2 due to periprosthetic capsula. In total, 9 implants were lost (6.5%). Esthetical results were mostly very satisfying and quality of life was not affected by the mastectomy. RSNM with IPBR was associated with low rates of major necrosis. It is a safe and reproducible procedure that allows breast reconstruction without visible scar.
机器人乳房手术是一种新兴的手术，具有令人鼓舞的初步结果。本研究旨在评估机器人乳头保留乳房切除术（RNSM）联合即刻假体乳房重建（IPBR）的可行性和安全性。这是一项前瞻性研究，纳入了 2015 年 12 月至 2020 年 1 月期间所有接受 RNSM 联合 IPBR 的中度乳房下垂和 A、B 或 C 罩杯患者。主要终点是主要坏死的发生率。次要终点是转化率、术后并发症（感染、血肿、假体暴露）、美学效果和生活质量。79 例患者接受了 138 例 RNSM 联合 IPBR。平均随访 28 个月。2 例需要转换。发生 2 例主要坏死（1.4%）。观察到 9 例手术部位感染（6.5%），其中 4 例可通过更换假体进行治疗。不幸的是，另外 5 例导致假体丢失。另外 4 例假体丢失：2 例由于主要坏死，2 例由于假体周围包膜。总共丢失了 9 个假体（6.5%）。美学效果大多非常满意，生活质量不受乳房切除术的影响。RNSM 联合 IPBR 与较低的主要坏死发生率相关。这是一种安全且可重复的手术，可在不留下可见疤痕的情况下进行乳房重建。
