机器人与传统乳腺癌保留乳头乳晕皮下腺体切除即刻假体乳房重建术疗效对比研究  

A retrospective study of robotic versus conventional nipple sparing mastectomy immediate breast reconstruction with gel implant for breast cancer

作　　者：陈阔 吕鹏威[1] CHEN Kuo;LYU Peng-wei(Department of Breast Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院乳腺外科,河南郑州450052

出　　处：《中国实用外科杂志》2024年第11期1276-1280,1285,共6页Chinese Journal of Practical Surgery

摘　　要：目的通过与传统乳腺癌保留乳头乳晕皮下腺体切除即刻假体乳房重建术(CNSMIBR)对比,探索机器人乳腺癌保留乳头乳晕皮下腺体切除即刻假体乳房重建术(RNSMIBR)临床应用的有效性及安全性。方法回顾性分析2022年4月至2024年4月于郑州大学第一附属医院乳腺外科行CNSMIBR(93例)和RNSMIBR(107例)女性乳腺癌病人的临床资料,包括临床病理特征、手术类型、手术时间和围手术期并发症等。结果RNSMIBR组手术时间高于CNSMIBR组,差异有统计学意义[(210.06±56.47)min vs.(165.27±35.19)min,P<0.001]。术后随访CNSMIBR组病人因感染导致1例假体取出,RNSMIBR组病人2例假体取出。RNSMIBR组病人3例发生皮肤红肿。两组病人均发生3例上肢淋巴水肿。两组病人乳头后切缘阳性率为0,无乳头乳晕复合体坏死等并发症发生。结论尽管目前的证据仍然有限且随访时间较短,但初步研究结果显示,RNSMIBR在疗效和安全性方面与传统开放手术方式相当。随着时间的推移和病例数量的增加,其学习曲线预计将逐步缩短。因此,RNSMIBR有望成为一种可供病人选择的手术方式,并可能引领未来乳腺外科手术的发展趋势。Objective To explore the clinical efficacy and safety of robotic nipple sparing mastectomy immediate breast reconstruction(RNSMIBR)with gel implant for breast cancer via its comparison with conventional nipple sparing mastectomy immediate breast reconstruction(CNSMIBR).Methods Clinical data of woman patients who underwent CNSMIBR(n=93)and RNSMIBR(n=107)at Department of Breast Surgery,the First Affiliated Hospital of Zhengzhou University between April 2022 and April 2024 was retrospectively analyzed,including,clinicopathological characteristics,type of surgery,duration of surgery,and perioperative complications.Results The operation time of RNSMIBR group was higher than that of CNSMIBR group,and the difference was statistically significant[(210.06±56.47)min vs.(165.27±35.19)min,P<0.001].The operative time was different because of the axillary approach,but there was no significant disadvantage of robotic surgery.During the postoperative follow-up,1 implant was removed in the CNSMIBR group due to infection and 2 implants were removed in the RNSMIBR group.Skin erythema occurred in 3 patients in the RNSMIBR group.The two groups had 3 cases of upper extremity lymphedema.The rate of positive posterior nipple margins in the 2 groups was 0,and there were no complications such as necrosis of the nipple-areola complex.Conclusion Although current evidence is limited and follow-up time is relatively short,preliminary results suggest that RNSMIBR is comparable to conventional open surgical approaches in terms of efficacy and safety.Its learning curve is expected to become progressively shorter over time and as the number of cases increases.Therefore,RNSMIBR is expected to become an available surgical option for patients and may lead the future trend of breast surgery.

关 键 词：乳腺癌 机器人手术 乳房重建 假体 

分 类 号：R6[医药卫生—外科学]