Clinical effect of axillary approach endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Ziteng , LI Zongyan , FU Xiaoyan ,  LI Haiyan

Department of Breast Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, P. R. China;

Corresponding?author：

LI Haiyan, Email: lihy27@mail.sysu.edu.cn

Keywords：

breast cancer; laparoscopy; immediate prosthetic breast reconstruction; dual-main surgeons’ surgery

DOI：

10.7507/1007-9424.202209020

Video：

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Objective To summarize the experience of 23 cases of axillary approach endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction, and to discuss its superiority and patient satisfaction. Methods The clinical data of 23 female breast cancer patients who underwent axillary approach endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction from June 2021 to June 2022 in the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively included. We summarized the surgical procedures, surgical safety, and postoperative patient satisfaction. Results Twenty-three patients have operated the axillary approach endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction successfully without nipple reconstruction. Among them, 9 patients underwent dual-main surgeons’ surgery, and 14 patients underwent one-main surgeon surgery. The surgery time ranges from 3.5 to 7.0 h, mean of 4.76 h, and the mean operation time of 9 patients underwent dual-main surgeons’ surgery was shorter than that of patients underwent one-main surgeons’ surgery. The blood loss ranges from 20 to150 mL, mean of 45.7 mL. The postoperative hospital stay range from 0 to 24 d, mean of 10.7 d. Four people suffered from complications: 1 patient with prosthesis moving up, 2 patients with nipple-areola complications, and 1 patient with subcutaneous emphysema. All 23 women were followed for 3 months, and no one suffered from recurrence, metastasis, and death during this period. We surveyed people by BREAST-Q scale when pre-operation, 1 month after the operation, and 3 months after the operation. Compared with preoperative patients, the sexual well-being, psychosocial well-being, and chest physical well-being of 1 month postoperative patients were decreased, but obviously increased in 2 months. The satisfaction with breast of 3 months of postoperative patients were higher than preoperative patients. Conclusions Endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction can achieve good cosmetic results and improve surgical safety. The dual-main surgeons’ surgery can decrease the operation time, so as to reduce the risk of anesthesia for patients.

Citation： LIU Ziteng, LI Zongyan, FU Xiaoyan, LI Haiyan. Clinical effect of axillary approach endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(11): 1427-1432. doi: 10.7507/1007-9424.202209020 Copy

1.	WHO: Geneva, Switzerland. Breast cancer. [2021-02-03]. http://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/.
2.	Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: Cancer today. [2020-04-05]. https://gco.iarc.fr/today/.
3.	Liu PH, Wei JC, Wang YH, et al. Female breast cancer incidence predisposing risk factors identification using nationwide big data: a matched nested case-control study in Taiwan. BMC Cancer, 2022, 22(1): 849. doi: 10.1186/s12885-022-09913-6.
4.	邵志敏, 沈鎮宙, 徐兵河. 乳腺中腫瘤學. 第 2 版, 上海: 復旦大學出版社, 2018: 470-488.
5.	Lai HW, Chen ST, Liao CY, et al. Oncologic outcome of endoscopic assisted breast surgery compared with conventional approach in breast cancer: An analysis of 3 426 primary operable breast cancer patients from single institute with and without propensity score matching. Ann Surg Oncol, 2021, 28(12): 7368-7380.
6.	李娟, 唐慶, 馮玉, 等. 雙側乳房切除術后即刻植入物乳房重建: 腔鏡與傳統開放手術的比較. 中國胸心血管外科臨床雜志: 1-8 [2022-10-08]. http://kns.cnki.net/kcms/detail/51.1492.r.20220310.0928.002.html.
7.	朱壁法, 陶維陽. 乳腔鏡在乳腺癌外科治療中的研究進展. 現代腫瘤醫學, 2017, 25(24): 4069-4072.
8.	中華醫學會外科學分會內分泌外科學組. 乳腺疾病腔鏡手術技術操作指南 (2016版). 中華乳腺病雜志(電子版), 2016, 10(4): 193-199.
9.	馬宏巖. 乳腺癌微創治療的研究進展. 中國普外基礎與臨床雜志, 2010, 17(3): 214-218.
10.	陳濤, 賈琳嬌, 翟保平, 等. 腔鏡輔助乳房重建手術方式的研究進展. 中華乳腺病雜志(電子版), 2019, 13(2): 124-126.
11.	Zhang S, Xie Y, Liang F, et al. Endoscopic-assisted nipple-sparing mastectomy with direct-to-implant subpectoral breast reconstruction in the management of breast cancer. Plast Reconstr Surg Glob Open, 2021, 9(12): e3978. doi: 10.1097/GOX.0000000000003978.
12.	Zhang S, Xie Y, Liang F, et al. Video-assisted transaxillary nipple-sparing mastectomy and immediate implant-based breast reconstruction: a novel and promising method. Aesthetic Plast Surg, 2022, 46(1): 91-98.
13.	Ho WS, Ying SY, Chan AC. Endoscopic-assisted subcutaneous mastectomy and axillary dissection with immediate mammary prosthesis reconstruction for early breast cancer. Surg Endosc, 2002, 16(2): 302-306.
14.	屈翔, 王子函, 王勁夫, 等. 腔鏡手術在乳腺癌外科的應用與前景. 中國實用外科雜志, 2018, 38(11): 1245-1248.
15.	覃湘泉, 王甜甜, 謝妍妍, 等. 腋窩入路腔鏡下乳腺癌皮下腺體切除聯合胸肌前假體+補片Ⅰ期乳房重建的創新探索. 中國胸心血管外科臨床雜志, 2021, 28(9): 1029-1036.
16.	周嬌, 梁法清, 謝妍妍, 等. 華西醫院日間腔鏡乳腺皮下切除聯合一期假體重建的臨床路徑簡介. 中國胸心血管外科臨床雜志, 2021, 28(12): 1393-1399.
17.	Zhou J, Liu X, Feng Y, et al. Breakthrough in breast reconstruction in the context of COVID-19: safety and efficiency of endoscopic breast reconstruction at a day surgery center. Gland Surg, 2021, 10(8): 2477-2489.
18.	江學成. 麻醉和手術風險數字化評估方法解讀. 臨床麻醉學雜志, 2007, 23(11): 947-949.
19.	郭凱紅. 普外科術后下肢深靜脈血栓形成的危險因素及預防措施. 中國醫藥指南, 2019, 17(25): 48.
20.	李云峰, 尹新民. "雙主刀"模式在腹腔鏡解剖性肝切除術中的應用. 中國醫師雜志, 2018, 20(10): 1441-1443.
21.	羅雙靈, 康亮. taTME的學習曲線和規范化培訓. 結直腸肛門外科, 2022, 28(1): 10-13.
22.	Lim SM, Lam FL. Laparoscopic-assisted axillary dissection in breast cancer surgery. Am J Surg, 2005, 190(4): 641-643.
23.	姜軍, 梁燕, 艾翔, 等. 我國乳腺腔鏡手術現狀與困境. 中國實用外科雜志, 2020, 40(10): 1130-1134.

1. WHO: Geneva, Switzerland. Breast cancer. [2021-02-03]. http://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/.
2. Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: Cancer today. [2020-04-05]. https://gco.iarc.fr/today/.
3. Liu PH, Wei JC, Wang YH, et al. Female breast cancer incidence predisposing risk factors identification using nationwide big data: a matched nested case-control study in Taiwan. BMC Cancer, 2022, 22(1): 849. doi: 10.1186/s12885-022-09913-6.
4. 邵志敏, 沈鎮宙, 徐兵河. 乳腺中腫瘤學. 第 2 版, 上海: 復旦大學出版社, 2018: 470-488.
5. Lai HW, Chen ST, Liao CY, et al. Oncologic outcome of endoscopic assisted breast surgery compared with conventional approach in breast cancer: An analysis of 3 426 primary operable breast cancer patients from single institute with and without propensity score matching. Ann Surg Oncol, 2021, 28(12): 7368-7380.
6. 李娟, 唐慶, 馮玉, 等. 雙側乳房切除術后即刻植入物乳房重建: 腔鏡與傳統開放手術的比較. 中國胸心血管外科臨床雜志: 1-8 [2022-10-08]. http://kns.cnki.net/kcms/detail/51.1492.r.20220310.0928.002.html.
7. 朱壁法, 陶維陽. 乳腔鏡在乳腺癌外科治療中的研究進展. 現代腫瘤醫學, 2017, 25(24): 4069-4072.
8. 中華醫學會外科學分會內分泌外科學組. 乳腺疾病腔鏡手術技術操作指南 (2016版). 中華乳腺病雜志(電子版), 2016, 10(4): 193-199.
9. 馬宏巖. 乳腺癌微創治療的研究進展. 中國普外基礎與臨床雜志, 2010, 17(3): 214-218.
10. 陳濤, 賈琳嬌, 翟保平, 等. 腔鏡輔助乳房重建手術方式的研究進展. 中華乳腺病雜志(電子版), 2019, 13(2): 124-126.
11. Zhang S, Xie Y, Liang F, et al. Endoscopic-assisted nipple-sparing mastectomy with direct-to-implant subpectoral breast reconstruction in the management of breast cancer. Plast Reconstr Surg Glob Open, 2021, 9(12): e3978. doi: 10.1097/GOX.0000000000003978.
12. Zhang S, Xie Y, Liang F, et al. Video-assisted transaxillary nipple-sparing mastectomy and immediate implant-based breast reconstruction: a novel and promising method. Aesthetic Plast Surg, 2022, 46(1): 91-98.
13. Ho WS, Ying SY, Chan AC. Endoscopic-assisted subcutaneous mastectomy and axillary dissection with immediate mammary prosthesis reconstruction for early breast cancer. Surg Endosc, 2002, 16(2): 302-306.
14. 屈翔, 王子函, 王勁夫, 等. 腔鏡手術在乳腺癌外科的應用與前景. 中國實用外科雜志, 2018, 38(11): 1245-1248.
15. 覃湘泉, 王甜甜, 謝妍妍, 等. 腋窩入路腔鏡下乳腺癌皮下腺體切除聯合胸肌前假體+補片Ⅰ期乳房重建的創新探索. 中國胸心血管外科臨床雜志, 2021, 28(9): 1029-1036.
16. 周嬌, 梁法清, 謝妍妍, 等. 華西醫院日間腔鏡乳腺皮下切除聯合一期假體重建的臨床路徑簡介. 中國胸心血管外科臨床雜志, 2021, 28(12): 1393-1399.
17. Zhou J, Liu X, Feng Y, et al. Breakthrough in breast reconstruction in the context of COVID-19: safety and efficiency of endoscopic breast reconstruction at a day surgery center. Gland Surg, 2021, 10(8): 2477-2489.
18. 江學成. 麻醉和手術風險數字化評估方法解讀. 臨床麻醉學雜志, 2007, 23(11): 947-949.
19. 郭凱紅. 普外科術后下肢深靜脈血栓形成的危險因素及預防措施. 中國醫藥指南, 2019, 17(25): 48.
20. 李云峰, 尹新民. "雙主刀"模式在腹腔鏡解剖性肝切除術中的應用. 中國醫師雜志, 2018, 20(10): 1441-1443.
21. 羅雙靈, 康亮. taTME的學習曲線和規范化培訓. 結直腸肛門外科, 2022, 28(1): 10-13.
22. Lim SM, Lam FL. Laparoscopic-assisted axillary dissection in breast cancer surgery. Am J Surg, 2005, 190(4): 641-643.
23. 姜軍, 梁燕, 艾翔, 等. 我國乳腺腔鏡手術現狀與困境. 中國實用外科雜志, 2020, 40(10): 1130-1134.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical effect of axillary approach endoscopy-assisted bilateral skin-sparing mastectomy surgery with immediate prosthetic breast reconstruction

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