Gilles Houvenaeghel1, Marie Bannier2, Sandrine Rua2, Julien Barrou2, Mellie Heinemann3, Sophie Knight3, Eric Lambaudie3, Monique Cohen2. 1. Department of Surgical Oncology, Paoli Calmettes Institute and CRCM, CNRS, INSERM, Aix Marseille Université, 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: houvenaeghelg@ipc.unicancer.fr. 2. Department of Surgical Oncology, Paoli Calmettes Institute, 232 Bd de Sainte Marguerite, 13009, Marseille, France. 3. Department of Surgical Oncology, Paoli Calmettes Institute and CRCM, CNRS, INSERM, Aix Marseille Université, 232 Bd de Sainte Marguerite, 13009, Marseille, France.
Abstract
OBJECTIVE: To analyze results of the first 100 robotic breast surgeries: feasibility, morbidity, indications and standardization of patient positioning and operative technique. BACKGROUND: Robotic breast surgery is an emergent procedure. METHODS: A prospective cohort of patients undergoing robotic latissimus dorsi-flap reconstruction (RLDFR) and or robotic mastectomy, over a period of 24 months was analyzed. We analyzed patient's characteristics, previous treatment for breast cancer, primitive breast cancer or local recurrence, immediate or delayed breast reconstruction and type of reconstruction. Surgical techniques and duration of surgery were reported according to three successive periods. RESULTS: 46.2% of patients (37/80) had previous breast radiotherapy and 26.2% (21/80) had received neo-adjuvant chemotherapy. Surgical procedure and patient position are described. Surgical incision used for RLDFR was: 37 axillar (50.7%), 20 (27.4%) areolar, 7 (9.6%) central breast, 10 (13.7%) previous incision. Number of surgical procedures was >2 for 35 patients. In logistic regression, factors significantly associated with duration of surgery ≥305mn were: P2 with decreased operative duration (OR: 0.077, p = 0.002) and P3 (OR: 0.015, p < 0.0001) versus P1; and number of surgical procedures: 4 surgical procedures (OR: 15.60, p = 0.048) versus 1. Median hospital stay was 4 days. Total complication rate was 57.5% (46 patients) with 6 grade 2, 9 grade 3 and 1 grade 4 complication. For RLDFR we reported 1 grade 3 (1.3%) and 29 grade 1 (39.7%) complications consisting in dorsal seromas. CONCLUSION: RLDFR is a safe and reproducible procedure that allows breast reconstruction through a single incision, without dorsal scar. A decrease in surgery duration was observed with technique standardization and throughout the learning curve.
OBJECTIVE: To analyze results of the first 100 robotic breast surgeries: feasibility, morbidity, indications and standardization of patient positioning and operative technique. BACKGROUND: Robotic breast surgery is an emergent procedure. METHODS: A prospective cohort of patients undergoing robotic latissimus dorsi-flap reconstruction (RLDFR) and or robotic mastectomy, over a period of 24 months was analyzed. We analyzed patient's characteristics, previous treatment for breast cancer, primitive breast cancer or local recurrence, immediate or delayed breast reconstruction and type of reconstruction. Surgical techniques and duration of surgery were reported according to three successive periods. RESULTS: 46.2% of patients (37/80) had previous breast radiotherapy and 26.2% (21/80) had received neo-adjuvant chemotherapy. Surgical procedure and patient position are described. Surgical incision used for RLDFR was: 37 axillar (50.7%), 20 (27.4%) areolar, 7 (9.6%) central breast, 10 (13.7%) previous incision. Number of surgical procedures was >2 for 35 patients. In logistic regression, factors significantly associated with duration of surgery ≥305mn were: P2 with decreased operative duration (OR: 0.077, p = 0.002) and P3 (OR: 0.015, p < 0.0001) versus P1; and number of surgical procedures: 4 surgical procedures (OR: 15.60, p = 0.048) versus 1. Median hospital stay was 4 days. Total complication rate was 57.5% (46 patients) with 6 grade 2, 9 grade 3 and 1 grade 4 complication. For RLDFR we reported 1 grade 3 (1.3%) and 29 grade 1 (39.7%) complications consisting in dorsal seromas. CONCLUSION: RLDFR is a safe and reproducible procedure that allows breast reconstruction through a single incision, without dorsal scar. A decrease in surgery duration was observed with technique standardization and throughout the learning curve.
Authors: Antônio Luiz Frasson; Martina Lichtenfels; Alessandra Anton Borba de Souza; Betina Vollbrecht; Ana Beatriz Falcone; Mônica Adriana Rodriguez Martinez Frasson; Fernanda Barbosa Journal: Breast Cancer Res Treat Date: 2020-03-25 Impact factor: 4.872
Authors: Olivia Quilichini; Julien Barrou; Marie Bannier; Sandrine Rua; Aurore Van Troy; Laura Sabiani; Eric Lambaudie; Monique Cohen; Gilles Houvenaeghel Journal: Ann Med Surg (Lond) Date: 2020-12-31