达芬奇机器人在保留乳头乳晕乳腺切除即刻假体乳房再造术中应用的效果探讨  

Efficacy of da Vinci robotic nipple sparing mastectomy and immediate breast reconstruction with gel implant in breast cancer

作　　者：陈阔 宋达疆 吕鹏威[1] Chen Kuo;Song Dajiang;Lyu Pengwei(Department of Breast Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Oncology Plastic Surgery,the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University/Hunan Cancer Hospital,Changsha 410008,China)

机构地区：[1]郑州大学第一附属医院乳腺外科,郑州450052 [2]中南大学湘雅医学院附属肿瘤医院,湖南省肿瘤医院肿瘤整形外科,长沙410008

出　　处：《中华医学美学美容杂志》2024年第5期425-429,共5页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨达芬奇机器人在保留乳头乳晕即刻假体乳房再造术中应用的效果。方法2022年9月至2024年5月在郑州大学第一附属医院乳腺外科接受单侧达芬奇机器人保留乳头乳晕即刻假体乳房再造术治疗且符合纳入标准的乳腺癌女性患者116例,年龄17~58(42.1±7.2)岁,体重指数(22.93±2.53)kg/m^(2)。收集并分析入选患者的临床病理学特征、机器人镜下操作时间、总手术时间、围手术期并发症,以确定手术的有效性和实用性。结果14例患者使用达芬奇机器人SITM系统,102例患者使用达芬奇机器人XI系统。使用三孔三臂操作78例,单孔三臂操作38例。机器人镜下操作时间和总手术时间分别为(115.95±58.10)min和(205.14±57.72)min。机器人准备时间从最初的25 min减少到目前的5 min。术后随访时间(3±1)个月,无乳头乳晕复合体坏死;除2例假体丢失、5例皮肤发生热损伤外,109例患者无严重的围手术期并发症,且对术后美学效果满意。结论达芬奇机器人保留乳头乳晕即刻假体乳房再造手术能提供较好的美容效果,且无严重围手术期并发症。ObjectiveTo explore the effect of da Vinci robotic nipple sparing mastectomy and immediate breast reconstruction with gel implant in breast cancer.MethodsFrom September 2022 to May 2024,116 female patients with breast cancer,aged 17-58(42.1+7.2)years,with a body mass index(22.93+2.53)kg/m^(2),who underwent unilateral da Vinci robotic nipple-areola preserving immediate prosthetic breast reconstruction in the Department of Breast Surgery,the First Afiliated Hospital of Zhengzhou University,and who fulfilled the inclusion criteria.were enrolled in this study.The clinicopathologic characteristics,robotic microscopy time,total operative time,and perioperative complications of the patients were collected and analyzed to determine the effectiveness and usefulness of the procedure.ResultsThe da Vinci robotic SI system was utilized in 14 patients,while the da Vinci robotic X system was employed in 102 patients.A total of 78 three-port,three-arm operations and 38 single-port.three-arm operations were conducted.The mean robotic operating time and total operating time were(115.95±58.10)minutes and(205.14±57.72)minutes,respectively.Additionally,the robotic preparation time was reduced from the initial 25 minutes to the current 5 minutes.At the postoperative follow-up time of three months,no nipple-areola complex necrosis was observed,and no serious perioperative complications were identified in 109 patients,with the exception of two cases of implants loss and five cases of heat steam induced skin damage.With the exception of two cases of prosthesis loss and five instances of thermal skin injury,109 patients exhibited no significant perioperative complications and expressed satisfaction with the postoperative aesthetic outcomes.ConclusionsThe da Vinci robotic nipple sparing mastectomy and immediate breast reconstruction with gel implant has the potential to provide superior aesthetic outcomes without significant perioperative complications for the female patients.

关 键 词：乳腺癌 机器人手术 乳房再造 假体 美学效果 

分 类 号：R655.8[医药卫生—外科学]