Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2024 Sep;65(9):511-518. doi: 10.3349/ymj.2023.0348.
The use of advanced energy devices for mastectomy and axillary lymph node dissection can reduce perioperative blood loss, seroma formation, and drainage duration/volume. Retraction using fiberoptic retractors can help visualize deep and narrow surgical fields. We aimed to compare the postoperative outcomes between single-incision breast-conserving surgery (SIBCS) and conventional breast-conserving surgery (CBCS) with axillary staging using advanced energy devices and conventional equipment, respectively.
We retrospectively reviewed the medical records of 244 patients who underwent BCS with axillary surgery between March 2018 and September 2019 at Severance Hospital. The patients were grouped based on the device used to aid in axillary staging: CBCS group (n=117) used conventional electrocautery; and SIBCS group (n=127) used advanced energy devices and fiberoptic retractors. The two groups were compared for postoperative outcomes.
The mean patient age was 55.9 and 53.1 years in the CBCS and SIBCS groups, respectively. Incision size was significantly smaller in the SIBCS group than in the CBCS group (6.3±2.1 cm vs. 7.5±2.5 cm, =0.044). There were no significant differences between the two groups in terms of operating time (126.0±40.0 min vs. 127.0±63.0 min, =0.828), operative blood loss (11.0±31.0 mL vs. 7.0±18.0 mL, =0.100), drainage duration (7.0±3.0 d vs. 8.0±4.0 d, =0.288), and complications (1.70% vs. 2.36%, =0.523).
Using advanced energy devices for SIBCS with axillary staging reduced incision size and provided better cosmetic outcomes compared to those using the conventional method. Advanced energy devices may offer better surgical outcomes in patients who undergo BCS with axillary staging.
使用先进的能量设备进行乳房切除术和腋窝淋巴结清扫术可以减少围手术期失血、血清肿形成和引流持续时间/量。使用光纤牵开器回缩可以帮助可视化深部和狭窄的手术区域。我们旨在比较使用先进能量设备和常规设备分别辅助腋窝分期的单切口保乳手术(SIBCS)和常规保乳手术(CBCS)的术后结果。
我们回顾性分析了 2018 年 3 月至 2019 年 9 月在 Severance 医院接受腋窝手术的 244 例接受 BCS 的患者的病历。根据辅助腋窝分期使用的设备将患者分组:CBCS 组(n=117)使用常规电灼;SIBCS 组(n=127)使用先进能量设备和光纤牵开器。比较两组的术后结果。
CBCS 组和 SIBCS 组的患者平均年龄分别为 55.9 岁和 53.1 岁。SIBCS 组的切口尺寸明显小于 CBCS 组(6.3±2.1 cm vs. 7.5±2.5 cm,=0.044)。两组在手术时间(126.0±40.0 min vs. 127.0±63.0 min,=0.828)、手术出血量(11.0±31.0 mL vs. 7.0±18.0 mL,=0.100)、引流持续时间(7.0±3.0 d vs. 8.0±4.0 d,=0.288)和并发症发生率(1.70% vs. 2.36%,=0.523)方面无显著差异。
与传统方法相比,使用先进的能量设备进行 SIBCS 联合腋窝分期可减少切口大小并提供更好的美容效果。在接受腋窝分期的 BCS 患者中,先进的能量设备可能提供更好的手术结果。