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内镜下保留乳头乳晕复合体的全乳房切除术的初步经验及学习曲线：一项单中心回顾性研究

Preliminary experience and learning curve of endoscopic nipple-areolar-complex sparing total mastectomy: A single-center retrospective study.

作者信息

Yu Da Young, Lee Tae Yul, Kim Duk Woo, Chang Young Woo, Son Gil Soo, Lee Hye Yoon

机构信息

Division of Breast and Endocrine Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea.

Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea.

出版信息

PLoS One. 2025 Jan 9;20(1):e0311764. doi: 10.1371/journal.pone.0311764. eCollection 2025.

DOI:10.1371/journal.pone.0311764
PMID:39787177
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11717311/
Abstract

BACKGROUND

In this study, the preliminary experience of endoscopic nipple-areolar-complex (NAC) sparing total mastectomy were analyzed and reported.

METHODS

The medical records of the patients who underwent Endoscopic NAC sparing total mastectomy from November 2019 to June 2022 in a single institute were collected and analyzed. The medical records of their clinicopathologic characteristics, perioperative parameters, postoperative complications, oncologic results were collected retrospectively. The learning curve was evaluated using univariable and multivariable analyses and analyzed using the CUSUM method.

RESULTS

A total of 56 surgeries from 53 patients were analyzed. The mean total operation time was 272.50±66.74 minutes while mean oncologic mastectomy was 155.61±43.21 minutes. The mean postoperative hospital days were 9.85±4.70 days. In CUSUM analysis, the cases needed to decrease operation time were 10th. The overall complication rate related to implant was 15.09%. There were one locoregional recurrence patient and one distant metastasis and mortality patient observed during median follow-up of 19.12±12.01 months.

CONCLUSION

According to our preliminary study, endoscopic NAC sparing total mastectomy is a safe procedure, and the operation time can be reduced with accumulated surgical experience.

摘要

背景

在本研究中，分析并报告了内镜下保留乳头乳晕复合体（NAC）的全乳切除术的初步经验。

方法

收集并分析了2019年11月至2022年6月在一家机构接受内镜下保留NAC全乳切除术患者的病历。回顾性收集其临床病理特征、围手术期参数、术后并发症、肿瘤学结果等病历资料。使用单变量和多变量分析评估学习曲线，并采用累积和（CUSUM）方法进行分析。

结果

共分析了53例患者的56例手术。平均总手术时间为272.50±66.74分钟，平均肿瘤性乳房切除术时间为155.61±43.21分钟。术后平均住院天数为9.85±4.70天。在CUSUM分析中，需要缩短手术时间的病例为第10例。与植入物相关的总体并发症发生率为15.09%。在中位随访19.12±12.01个月期间，观察到1例局部区域复发患者、1例远处转移和死亡患者。

结论

根据我们的初步研究，内镜下保留NAC全乳切除术是一种安全的手术方法，随着手术经验的积累，手术时间可以缩短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25a/11717311/4ff8a6b2c734/pone.0311764.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25a/11717311/fc46a7f8c9a9/pone.0311764.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25a/11717311/4ff8a6b2c734/pone.0311764.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25a/11717311/fc46a7f8c9a9/pone.0311764.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25a/11717311/4ff8a6b2c734/pone.0311764.g002.jpg

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Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline.乳腺癌的新辅助化疗、内分泌治疗和靶向治疗：ASCO 指南。
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Evaluation of the Learning Curve in Robotic Nipple-sparing Mastectomy for Breast Cancer.
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Robot-assisted Nipple-sparing Mastectomy With Immediate Breast Reconstruction: An initial Experience of the Korea Robot-endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG).机器人辅助保留乳头的乳房切除术联合即刻乳房重建：韩国机器人内窥镜微创乳房外科研究组（KoREa-BSG）的初步经验。
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