Wu Zhijie, Liu Qiwen, Li Zongyan, Chen Zuxiao, Wu Yongxin, Luo Yunxiang, Wei Lina, Hu Qiongyu, Li Haiyan
Department of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Road, Guangzhou, 510655, Guangdong, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
World J Surg Oncol. 2025 May 9;23(1):179. doi: 10.1186/s12957-025-03794-2.
Robotic surgery is increasingly being adopted for breast cancer treatment. However, robust clinical evidence regarding its effectiveness and safety remains limited. This retrospective cohort study aimed to compare the surgical quality and short-term outcomes of robotic-assisted axillary lymph node dissection (R-ALND) and endoscopic-assisted axillary lymph node dissection (E-ALND) in patients with node-positive breast cancer. Here, we report the short-term outcomes of this trial.
This single-center retrospective study compared the short-term efficacy and safety of R-ALND and E-ALND in patients with node-positive breast cancer. Patients who underwent surgery at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2022 and October 2024 were included. Clinical and pathological characteristics, surgical outcomes, and postoperative complications were analyzed.
A total of 56 patients were included, with 29 undergoing E-ALND and 27 undergoing R-ALND. The R-ALND group demonstrated significantly shorter operative times (43.37 ± 12.40 min vs. 60.10 ± 19.37 min, p < 0.001) and lower mean intraoperative blood loss (3.26 ± 2.40 ml vs. 9.24 ± 4.29 ml, p < 0.001). Postoperatively, the R-ALND group exhibited better upper limb function and sensation, as evidenced by significantly lower DASH scores at 1-month (10.87 ± 1.35 vs. 14.64 ± 3.49, p < 0.001) and 3-month (6.68 ± 1.86 vs. 9.24 ± 2.74, p < 0.001) follow-ups. Additionally, the R-ALND group had fewer postoperative complications, including a reduced incidence of sensory disturbances, burning sensations, and numbness in the upper limb.
Compared with E-ALND, R-ALND significantly reduces intraoperative blood loss and postoperative complications, with less impact on upper limb function and sensory outcomes. These findings indicate that R-ALND may provide better clinical benefits for patients requiring axillary lymph node dissection in the management of breast cancer.
机器人手术在乳腺癌治疗中的应用越来越广泛。然而，关于其有效性和安全性的有力临床证据仍然有限。这项回顾性队列研究旨在比较机器人辅助腋窝淋巴结清扫术（R-ALND）和内镜辅助腋窝淋巴结清扫术（E-ALND）在淋巴结阳性乳腺癌患者中的手术质量和短期结局。在此，我们报告该试验的短期结局。
这项单中心回顾性研究比较了R-ALND和E-ALND在淋巴结阳性乳腺癌患者中的短期疗效和安全性。纳入了2022年1月至2024年10月在中山大学附属第六医院接受手术的患者。分析了临床和病理特征、手术结局及术后并发症。
共纳入56例患者，其中29例行E-ALND，27例行R-ALND。R-ALND组的手术时间显著更短（43.37±12.40分钟 vs. 60.10±19.37分钟，p<0.001），术中平均失血量更低（3.26±2.40毫升 vs. 9.24±4.29毫升，p<0.001）。术后，R-ALND组的上肢功能和感觉更好，在1个月（10.87±1.35 vs. 14.64±3.49，p<0.001）和3个月（6.68±1.86 vs. 9.24±2.74，p<0.001）随访时的DASH评分显著更低证明了这一点。此外，R-ALND组的术后并发症更少，包括上肢感觉障碍、烧灼感和麻木的发生率降低。
与E-ALND相比，R-ALND显著减少术中失血量和术后并发症，对上肢功能和感觉结局的影响更小。这些发现表明，R-ALND可能为乳腺癌治疗中需要腋窝淋巴结清扫的患者提供更好的临床益处。
