单孔充气法腔镜乳房皮下腺体切除术治疗早期乳腺癌的临床疗效

目的探讨单孔充气法腔镜乳房皮下腺体切除术在早期乳腺癌治疗中的肿瘤安全性,美容效果和上肢功能中的疗效和作用。方法回顾性选取2014年1月—2019年8月于首都医科大学附属北京友谊医院行单孔充气法腔镜乳房皮下腺体切除术的Ⅰ期及Ⅱ期乳腺癌患者80例,对肿瘤安全性,美容效果评分.上肢功能等进行评估。结果80例患者均成功完成单孔充气法腔镜乳房皮下腺体切除术,无严重并发症发生。术后随访16~82个月,中位随访时间为42个月。其中2例局部复发,无远处转移。4例(5%)出现1~3级乳头乳晕缺血。无一例皮下积液发生。通过Breast-Q量表进行评分,证实乳房满意度.胸璧状态满意度.社会心理状态满意度和性健康程度均获得较高评分。上肢功能评分证实术后保留了较好的上肢功能。切口长度(3.6±0.8)cm。出血量(24.7±19.3)ml。结论︰单孔充气法腔镜乳房皮下腺体切除术可以在保证肿瘤安全性的前提下获得较高的美容效果评分及较好的上肢功能恢复,可以作为早期乳腺癌患者手术方式的又一选择。

Clinical outcomes of single-port insufflation endoscopic subcutaneous nipple-sparing mastectomy in early breast cancer

Objective To discuss the oncologic safety,aesthetic outcome,and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy(SIE-NSM)in the treatment of early breast cancer.Methods F rom January 2014 to August 2019,a total of 80 patients with stage I and E breast cancer underwent SIE-NSM,at Beijing Friendship Hospital,Capital Medical University were retrospectively analyzed and followed up.Estimated the oncologic safety,aesthetic outcome,and upper extremity function.Results SIE-NSM was performed successfully on all 80 patients.There was no serious complication after surgery.The follow-up time was 16-82 months and the median follow-up time was 42 months.Local recurrence occurred in two patients,and there was no distant metastases.Four(5%)patients developed grade 1-3 nipple-areola complex ischemia.There were no cases of subcutaneous effusion.The satisfaction with breasts,chest well-being,psychosocial well-being,and sexual well-being scores were confirmed to be highly rated by Breast-Q scale.Upper extremity function score confirmed that good upper limb function was preserved after surgery.The mean length of incision was(3.6±0.8)cm,and the blood loss was(24.7±19.3)mL.Conclusions SIE-NSM can achieve a higher cosmetic score and a better recovery of upper limb function on the premise of ensuring the safety of the tumor.This novel method is an appropriate surgical option for patients with early breast cancer.