Choi Hee Jun, Paek Se Hyun, Lee Jun-Hee, Lee Min Hyuk, Bang Yoon Ju, Kim Ku Sang, Kim Hyun Yul, Park Hyung Seok, Ryu Jai Min
Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Department of Surgery, College of Medicine, Ewha Womans University, Chicago, IL, USA.
Surg Endosc. 2025 Aug 11. doi: 10.1007/s00464-025-11964-2.
Robot-assisted breast-conserving surgery has a potentially better cosmetic benefit than conventional breast-conserving surgery without any scarring on the breast. However, data on the feasibility and safety are limited. This study presents the results of early robot-assisted breast-conserving surgery.
A multi-center retrospective review was conducted to identify women who underwent robot-assisted breast- conserving surgery between August 2019 and October 2023. Information on the clinicopathological characteristics, perioperative complications, operation time, recurrence, and reoperation was collected.
A total of 150 patients underwent the surgery performed by ten breast surgeons at seven institutions. Invasive breast cancer was observed in 121 cases and ductal carcinoma in situ was detected in 29 cases. Of all the patients, 75.3% and 65.3% had an estrogen and progesterone receptor positive status, respectively. A total of 35.3% of the patients had a HER2-positive status. In terms of the surgical technique, the Da Vinci SP system was more frequently used (60%). Gas insufflation was applied in 97.33% of the cases, and sentinel lymph node biopsy was the most common axillary surgery (89.3%). The median postoperative days was 5.4 days. The incision location was the mid-axillary line, and the median incision length was 37.1 mm. The median total operation time was 133.8 min. Eleven cases (7.3%) had positive frozen margins, and only one case (0.7%) required reoperation because of permanent positive margin. Six patients (4%) developed surgical complications. Postoperative bleeding was found in one case and skin burns were found in five cases (3.3%). There were no cases of conversion to open surgery or of mortality. Two patient (1.3%) had recurrence.
This is the first multicenter report on robot-assisted breast-conserving surgery, suggesting the technique is feasible and safe. Further comparative and prospective studies are warranted to evaluate patient satisfaction, cost-effectiveness, and long-term surgical and oncological outcomes.
与传统保乳手术相比，机器人辅助保乳手术可能具有更好的美容效果，且乳房无疤痕。然而，关于其可行性和安全性的数据有限。本研究展示了早期机器人辅助保乳手术的结果。
进行了一项多中心回顾性研究，以确定2019年8月至2023年10月期间接受机器人辅助保乳手术的女性。收集了临床病理特征、围手术期并发症、手术时间、复发情况和再次手术等信息。
共有150例患者在7家机构由10位乳腺外科医生进行了手术。其中121例为浸润性乳腺癌，29例为导管原位癌。所有患者中，雌激素受体和孕激素受体阳性状态分别占75.3%和65.3%。共有35.3%的患者HER2呈阳性。在手术技术方面，达芬奇SP系统使用更为频繁（60%）。97.33%的病例采用了气体注入，前哨淋巴结活检是最常见的腋窝手术方式（89.3%）。术后中位天数为5.4天。切口位置为腋中线，中位切口长度为37.1毫米。中位总手术时间为133.8分钟。11例（7.3%）患者冰冻切缘阳性，仅有1例（0.7%）因永久切缘阳性需要再次手术。6例患者（4%）出现手术并发症。1例出现术后出血，5例（3.3%）出现皮肤烧伤。没有转为开放手术或死亡病例。2例患者（1.3%）出现复发。
这是关于机器人辅助保乳手术的首份多中心报告，表明该技术是可行且安全的。有必要进行进一步的比较性和前瞻性研究，以评估患者满意度、成本效益以及长期手术和肿瘤学结局。
