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内镜保乳手术与传统保乳手术治疗早期乳腺癌的比较:一项荟萃分析。

Comparison of endoscopic breast-conserving surgery versus conventional breast-conserving surgery for the treatment of early-stage breast cancer: a meta-analysis.

作者信息

Li Liwen, Liang Yiwen, Li Chunyan, Huang Miaoyan, Liang Weiming, Qin Tian

机构信息

The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, China.

出版信息

Front Oncol. 2024 Aug 6;14:1419123. doi: 10.3389/fonc.2024.1419123. eCollection 2024.

Abstract

INTRODUCTION

This meta-analysis seeks to evaluate the efficacy and safety of endoscopic breast-conserving surgery (E-BCS) compared to conventional breast cancer surgery (C-BCS) in patients diagnosed with early-stage breast cancer.

MATERIALS AND METHODS

Four databases (Medline, Embase, Web of Science and CENTRAL) were searched published from establishment of database to January 30,2024, for articles studying E-BCS compared to C-BCS in patients diagnosed with early-stage breast cancer. Meta-analyses of procedure time, blood loss, length of incision, drainage duration, total postoperative drainage volume, average duration of hospital stay, positive rate of margin, complication rate, recurrence rate, metastasis rate and cosmetic scoring were performed.

RESULTS

Totally 11 studies were included for meta-analysis. Compared with C-BCS, E-BCS exhibited significantly reduced incision length (WMD = -6.44, 95%CI: -10.78 to -2.11, P=0.004, I = 99.0%) and superior cosmetic scoring (WMD = 2.69, 95%CI: 1.46 to 3.93, P=0.001, I = 93.2%), but had significantly longer operation time (WMD = 34.22, 95%CI: 20.89~47.55, P=0.000, I = 90.7%) and blood loss (WMD = 3.65, 95%CI: -3.12 to 10.43, P=0.291, I = 86.8%). There was no significant difference in terms of recurrence rate, metastasis rate, positive rate of tumor resection margins, drainage duration, drainage volume, complication rate and hospital days.

CONCLUSIONS

Our research findings indicate that E-BCS is a viable and secure method for treating breast cancer in its early stages. E-BCS provides distinct advantages in terms of the length of the incision and the aesthetic result, without demonstrating an elevated recurrence rate or metastasis rate.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024535164, identifier CRD42024535164.

摘要

引言

本荟萃分析旨在评估与传统乳腺癌手术(C-BCS)相比,内镜保乳手术(E-BCS)在早期乳腺癌患者中的疗效和安全性。

材料与方法

检索了四个数据库(Medline、Embase、Web of Science和CENTRAL),从数据库建立至2024年1月30日发表的关于比较E-BCS与C-BCS在早期乳腺癌患者中的研究文章。对手术时间、失血量、切口长度、引流持续时间、术后总引流量、平均住院时间、切缘阳性率、并发症发生率、复发率、转移率和美容评分进行荟萃分析。

结果

共纳入11项研究进行荟萃分析。与C-BCS相比,E-BCS的切口长度显著缩短(加权均数差[WMD]=-6.44,95%置信区间[CI]:-10.78至-2.11,P=0.004,I²=99.0%),美容评分更高(WMD=2.69,95%CI:1.46至3.93,P=0.001,I²=93.2%),但手术时间显著延长(WMD=34.22,95%CI:20.89至47.55,P=0.000,I²=90.7%),失血量也显著增加(WMD=3.65,95%CI:-3.12至10.43,P=0.291,I²=86.8%)。在复发率、转移率、肿瘤切除切缘阳性率、引流持续时间、引流量、并发症发生率和住院天数方面无显著差异。

结论

我们的研究结果表明,E-BCS是治疗早期乳腺癌的一种可行且安全的方法。E-BCS在切口长度和美学效果方面具有明显优势,且未显示复发率或转移率升高。

系统评价注册

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024535164,标识符CRD42024535164。

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