黑龙江省达芬奇机器人乳腺癌NSM操作指南专家共识(2024版)  

Expert consensus of operating instructions on robotic⁃assisted nipple⁃sparing mastectomy in Heilongjiang province

作　　者：黑龙江省达芬奇机器人乳腺癌NSM操作指南专家组 许守平 XU Shouping

机构地区：[1]不详 [2]哈尔滨医科大学附属肿瘤医院

出　　处：《中国肿瘤外科杂志》2025年第1期1-4,共4页Chinese Journal of Surgical Oncology

基　　金：黑龙江省重点研发计划(2022ZX06C0062)。

摘　　要：传统乳腺单切术不仅造成乳腺缺失,在胸壁形成横行或者纵行长切口,而且对皮肤感觉神经的离断造成胸壁和腋窝感觉功能异常(瘢痕体质患者更为严重),同时不同程度限制上肢和肩关节活动范围。形体美观缺失和感觉功能异常是造成患者生理缺陷和心理伤害的重要因素,使得部分患者治疗后不能完全回归社会。保留乳头乳晕的皮下腺体切除术(NSM)在充分切除乳房腺体的同时保留了乳头乳晕及胸壁皮肤,可在不影响上肢功能同时维持乳腺基本美观。达芬奇机器人的应用使得NSM的开展更加方便,其优点为切口隐蔽且微小,同时又能完成复杂手术的操作,出血少,对机体干扰小,治疗效果确切,并发症少。最突出的特点是微创、美容和功能保留。近年来,达芬奇机器人辅助下NSM技术(RNSM)在国内外开展迅速,笔者中心对于RNSM术前、术中及术后相关事宜予以总结梳理,供广大同行参考。Traditional mastectomy not only causes the absence of mammary glands and the formation of transverse or longitudinal incisions in the chest wall,but also causes abnormal sensory functions in the chest wall and armpit(more serious in patients with cicatricial body)due to the disconnection of sensory nerves in the skin,and restricts the range of motion of the upper limb and shoulder joints to varying degrees.Lack of aesthetic appearance and abnormal sensory function are important factors that cause physiological defects and psychological damage of patients,which makes patients unable to fully return to society after treatment.Subcutaneous glandectomy with nipple areola⁃sparing mastectomy(nipple⁃sparing mastectomy,NSM)can maintain the basic beauty of the breast without affecting the function of the upper limb.Application of Da Vinci robot makes the development of NSM more convenient,with hidden and small incision,less bleeding and interference to body,and precise treatment effect and fewer complications.The most prominent features are minimally invasive,cosmetic and functional preservation.In recent years,Da Vinci robot⁃assisted technology(robotic⁃assisted nipple⁃sparing mastectomy,RNSM)has been updated and developed rapidly at home and abroad,and the center has summarized and sorted out relevant matters before,during and after RNSM for the reference of the majority of peers.

关 键 词：皮下腺体切除术 乳腺癌 达芬奇机器人 操作指南 专家共识 

分 类 号：R737.9[医药卫生—肿瘤]