Chen Yongqiang, Xu Jianhua, Hong Shanyan, Xu Shuangta
Department of Thyroid Breast Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Gastroenteroesophageal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Transl Cancer Res. 2024 Feb 29;13(2):752-761. doi: 10.21037/tcr-23-1771. Epub 2024 Feb 28.
Endoscopic surgery for malignant breast tumors is becoming more and more popular and has been applied in the clinical setting. Single-port endoscopic-assisted radical mastectomy in retrograde way and immediate reconstruction using prosthesis implantation are rare. Therefore, this study described a new endoscopic technique for breast surgery.
This is a cross-sectional study. A total of 12 patients with breast cancer diagnosed in the Department of Thyroid Breast Surgery of The Second Affiliated Hospital of Fujian Medical University from January 2019 to June 2022 were retrospectively selected and underwent axillary single-port endoscopic-assisted radical mastectomy in retrograde way and immediate reconstruction using prosthesis implantation.
The average operation time was 190.25±25.40 min, the average blood loss was 86.25±33.11 mL, the average drainage volume was 207.92±65.90 mL 3 days after surgery, and the average hospital stay was 9.67±2.57 days. The follow-up period ranged from 11 to 21 months, with an average of 16.75 months. Medial paresthesia was present in only one patient, which decreased or disappeared after 3 months. No complications such as wound infection or limb dysfunction occurred in the remaining patients. Postoperative follow-up showed that 10 patients were very satisfied, one patient was relatively satisfied, and one patient was not satisfied.
Preliminary data attested the feasibility and the safety of this approach. It can improve patient satisfaction compared with traditional modified radical mastectomy for suitable candidates. However, long-term data are needed to confirm the oncological safety and the esthetic stability of the result.
内镜手术治疗乳腺恶性肿瘤越来越受欢迎，并已应用于临床。逆行单孔内镜辅助根治性乳房切除术及假体植入即刻重建术较为少见。因此，本研究描述了一种新的乳腺手术内镜技术。
本研究为横断面研究。回顾性选取2019年1月至2022年6月在福建医科大学附属第二医院甲状腺乳腺外科确诊的12例乳腺癌患者，行逆行腋窝单孔内镜辅助根治性乳房切除术及假体植入即刻重建术。
平均手术时间为190.25±25.40分钟，平均出血量为86.25±33.11毫升，术后3天平均引流量为207.92±65.90毫升，平均住院时间为9.67±2.57天。随访时间为11至21个月，平均16.75个月。仅1例患者出现内侧感觉异常，3个月后减轻或消失。其余患者未发生伤口感染或肢体功能障碍等并发症。术后随访显示，10例患者非常满意，1例患者比较满意，1例患者不满意。
初步数据证实了该方法的可行性和安全性。对于合适的患者，与传统改良根治性乳房切除术相比，它可以提高患者满意度。然而，需要长期数据来证实肿瘤学安全性和结果的美学稳定性。
