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单孔非吸脂近红外腹腔镜与传统开放手术在早期乳腺癌腋窝前哨淋巴结活检中的比较:一项单中心、小样本回顾性研究。

Comparison of single-pore non-liposuction near-infrared laparoscopy with conventional open surgery for axillary sentinel lymph node biopsy in patients with early breast cancer: a single-center, small-sample retrospective study.

机构信息

Sixth Affiliated Hospital of South China University of Technology, and Sixth Clinical College of South China University of Technology, Foshan, 528225, People's Republic of China.

Department of Breast Surgery, Sixth Affiliated Hospital of South China University of Technology, and Sixth Clinical College of South China University of Technology, Foshan, 528225, People's Republic of China.

出版信息

World J Surg Oncol. 2023 Feb 28;21(1):66. doi: 10.1186/s12957-023-02942-w.

Abstract

BACKGROUND

This study aimed to compare the effects of single-pore non-liposuction near-infrared (NIR) endoscopic surgery and traditional open surgery for axillary sentinel lymph node biopsy (SLNB) in patients with early breast cancer (EBC).

METHODS

The clinical pathological data of 61 patients with EBC who underwent axillary SLNB using indocyanine green (ICG) combined with carbon nanoparticle suspension (CNS) were retrospectively collected. Thirty patients received SLNB through single-pore non-liposuction NIR endoscopic surgery (endoscopic group), and the remaining 31 received SLNB through open-incision surgery (open group). The success rate, operation time, volume of intraoperative bleeding, postoperative axillary drainage, axillary extubation time, and the occurrence of postoperative complications were compared between the groups along with the total number of sentinel lymph nodes (SLNs), luminous SLNs, stained SLNs, and the pathological positivity rate of the SLNs.

RESULTS

All patients underwent SLNB with a 100% success rate. SLNB operation times of the endoscopic group were longer than those of the open group (t = 3.963, P = 0.000), and the volume of axillary drainage was inferior (t = 3.035, P = 0.004). However, there were no differences in the intraoperative bleeding volumes, axillary extubation times, and postoperative complications (P > 0.05). In the Open group, the mean number of SLNs was 5.12 ± 2.16, and the pathological positivity rate was 13.53%; in the Endoscopic group, these numbers were 4.89 ± 1.73 and 12.39%. The mean number of SLNs detected (t = 0.458, P = 0.649) and the pathological positivity rates (χ2 = 0.058, P = 0.810) did not differ between the two groups. All 61 patients were followed for a median of 14.6 months. There were no local recurrences or distant metastases.

CONCLUSIONS

Our single-center results reveal that single-hole non-liposuction NIR endoscopic axillary SLNB is not inferior to open SLNB and may be an appropriate option for patients with early breast cancer who desire breast preservation with fewer incisions.

TRIAL REGISTRATION

This retrospective study was "retrospectively registered" at the Sixth Affiliated Hospital of South China University of Technology (no. 2020105) and in National Medical Research Registration and Archival Information System ( https://www.medicalresearch.org.cn , number: MR-44-21-004727).

摘要

背景

本研究旨在比较单孔非吸脂近红外(NIR)内镜手术与传统开放式手术在早期乳腺癌(EBC)患者腋窝前哨淋巴结活检(SLNB)中的效果。

方法

回顾性收集 61 例采用吲哚菁绿(ICG)联合碳纳米颗粒混悬液(CNS)行腋窝 SLNB 的 EBC 患者的临床病理资料。30 例患者采用单孔非吸脂 NIR 内镜手术(内镜组)进行 SLNB,其余 31 例患者采用开放式切口手术(开放组)进行 SLNB。比较两组间手术成功率、手术时间、术中出血量、术后腋窝引流量、腋窝拔管时间及术后并发症发生情况,同时比较两组间总 SLN 数、发光 SLN 数、染色 SLN 数及 SLN 病理阳性率。

结果

所有患者均 100%成功进行了 SLNB。内镜组的 SLNB 手术时间长于开放组(t=3.963,P=0.000),且腋窝引流体积较小(t=3.035,P=0.004)。然而,两组间术中出血量、腋窝拔管时间及术后并发症发生率差异无统计学意义(P>0.05)。开放组 SLN 平均数量为 5.12±2.16,病理阳性率为 13.53%;内镜组分别为 4.89±1.73 和 12.39%。两组间检测到的 SLN 平均数量(t=0.458,P=0.649)和病理阳性率(χ2=0.058,P=0.810)差异无统计学意义。61 例患者均接受中位随访 14.6 个月。无局部复发或远处转移。

结论

本单中心研究结果表明,单孔非吸脂 NIR 内镜腋窝 SLNB 并不逊于开放式 SLNB,对于希望保乳且切口较少的早期乳腺癌患者,可能是一种合适的选择。

试验注册

本回顾性研究在华南理工大学附属第六医院(编号 2020105)和国家医学研究登记与档案库信息系统(https://www.medicalresearch.org.cn,编号:MR-44-21-004727)中进行了“回顾性注册”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca36/9972847/313a93598960/12957_2023_2942_Fig1_HTML.jpg

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