Department of Surgery, Division of Breast Surgery, Changi General Hospital.
SingHealth Duke-NUS Breast Centre, Singapore, Singapore.
Int J Surg. 2024 Sep 1;110(9):5463-5470. doi: 10.1097/JS9.0000000000001674.
Robotic mastectomy has been performed worldwide since 2015. The advantages of the robotic approach in nipple-sparing mastectomy have been proven with better visualization and preservation of blood supply to the nipple-areolar complex, with a lower incidence of necrosis. It also allows smaller incisions for both mastectomy and immediate breast reconstruction. To date, no centers in Singapore and Southeast Asia offer robotic mastectomy. We believe that robotic mastectomy is a feasible and safe technique that our population can utilize.
This study aimed to ascertain the surgical outcomes and perform a learning curve analysis in patients undergoing robotic mastectomy in a multi-ethnic South East Asian population.
A single-arm prospective pilot study of eligible patients aged 21-70 years old with early breast cancer or high-risk patients indicated for risk-reducing mastectomy who were eligible and consented to robotic mastectomy were enrolled in this trial from December 22, 2022 to December 15, 2023.
A total of 29 consecutive robotic mastectomies were performed. The mean total operative time was 95±10.2 min. The average blood loss was 5.7±1.9 ml, and the average length of stay was 1.05 days. The mean mastectomy specimen weight was 251 g, and there was no conversion to conventional mastectomy in any case. Furthermore, there were no 30-day morbidity or complications in terms of wound infection requiring intervention, flap, and nipple-areolar complex necrosis, and postoperative hematoma/bleeding requiring intervention.
This study contributes to the current evidence that robotic mastectomy is a safe and feasible option and could prove to be a great alternative to conventional mastectomy. Further prospective trials examining the long-term oncological outcomes of robotic mastectomy will be performed to establish the oncologic safety of this technique in breast cancer treatment.
自 2015 年以来,全球已开展机器人辅助乳房切除术。机器人辅助保乳乳房切除术的优势已得到证实,它具有更好的可视化效果,并且能更好地保护乳头乳晕复合体的血供,降低坏死的发生率。它还可以使乳房切除术和即刻乳房重建的切口更小。迄今为止,新加坡和东南亚没有任何中心提供机器人辅助乳房切除术。我们相信机器人辅助乳房切除术是一种可行且安全的技术,我们的人群可以使用。
本研究旨在确定在东南亚多种族人群中进行机器人辅助乳房切除术的手术结果,并进行学习曲线分析。
2022 年 12 月 22 日至 2023 年 12 月 15 日,对年龄在 21-70 岁之间的早期乳腺癌或有指征进行保乳预防性乳房切除术的高危患者进行了一项单臂前瞻性试点研究,纳入了符合条件并同意进行机器人辅助乳房切除术的患者。
共完成 29 例连续机器人乳房切除术。平均总手术时间为 95±10.2 分钟。平均失血量为 5.7±1.9ml,平均住院时间为 1.05 天。平均乳房切除术标本重量为 251g,无任何病例转为常规乳房切除术。此外,无 30 天发病率或并发症,如需要干预的伤口感染、皮瓣和乳头乳晕复合体坏死,以及需要干预的术后血肿/出血。
本研究为机器人乳房切除术是一种安全可行的选择提供了现有证据,并可能成为常规乳房切除术的替代方案。进一步开展前瞻性试验,研究机器人乳房切除术的长期肿瘤学结果,将有助于确定该技术在乳腺癌治疗中的肿瘤学安全性。