Hung-Wen Lai1, Shou-Tung Chen2, Chi Wei Mok3, Ying-Jen Lin4, Hwa-Koon Wu5, Shih-Lung Lin6, Dar-Ren Chen7, Shou-Jen Kuo8. 1. Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, Changhua 500, Taiwan; Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan; Minimal invasive surgery research center, Changhua Christian Hospital, Changhua, Taiwan; Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Breast Surgery, Yuanlin Christian Hospital, Yuanlin, Taiwan; School of Medicine, National Yang Ming University, Taipei, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Chang Gung University College of Medicine, Taoyuan City, Taiwan; Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: 143809@cch.org.tw. 2. Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, Changhua 500, Taiwan; Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 1886@cch.org.tw. 3. Division of Breast Surgery, Department of Surgery, Changi General Hospital, Singapore; Singhealth Duke-NUS Breast Centre, Singapore. Electronic address: mok.chi.wei@singhealth.com.sg. 4. Tumor Center, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 180681@cch.org.tw. 5. Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 17597@cch.org.tw. 6. Division of Plastic and Reconstructive Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 103280@cch.org.tw. 7. Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, Changhua 500, Taiwan; Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 115045@cch.org.tw. 8. Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, Changhua 500, Taiwan; Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 40225@cch.org.tw.
Abstract
BACKGROUND: Robotic nipple sparing mastectomy (R-NSM), which uses the da Vinci surgical platform, could perform NSM and immediate breast reconstruction through a small and inconspicuous extra-mammary axillary or lateral chest incision. R-NSM was reported with extremely low nipple areolar complex (NAC) necrosis rate, good cosmetic results, and high patient satisfaction. However, there was little evidence available comparing the effectiveness and safety of R-NSM and conventional NSM (C-NSM) in the management of breast cancer. METHODS: A case control comparison study was conducted for patients with breast cancer who underwent R-NSM or C-NSM with immediate gel implant breast reconstruction (IGBR) from July 2011 to September 2019 at a single institution to compare the clinical outcomes, patient-reported esthetic results, and medical cost. RESULTS: According to the study design, 54 procedures of R-NSM were compared with 62 procedures of C-NSM in the surgical management of breast cancer combined with IGBR. Compared with C-NSM, R-NSM was associated with higher overall satisfaction (92% excellent and 8% good versus 75.6% excellent and 24.4% good, P = 0.046), and wound/scar related outcome in patient-reported esthetic results. The NAC ischemia/necrosis risk, overall complication rate, and blood loss were not significantly different between R-NSM and C-NSM groups. However, longer operation time and higher overall medical cost (10,877 ± 796 versus 5,702 ± 661 US Dollars, P<0.01) was observed in R-NSM group. CONCLUSION: Compared with C-NSM, R-NSM showed comparable clinical outcomes and favorable patients' satisfaction with the esthetic results, but at the price of longer operation time and higher cost.
BACKGROUND: Robotic nipple sparing mastectomy (R-NSM), which uses the da Vinci surgical platform, could perform NSM and immediate breast reconstruction through a small and inconspicuous extra-mammary axillary or lateral chest incision. R-NSM was reported with extremely low nipple areolar complex (NAC) necrosis rate, good cosmetic results, and high patient satisfaction. However, there was little evidence available comparing the effectiveness and safety of R-NSM and conventional NSM (C-NSM) in the management of breast cancer. METHODS: A case control comparison study was conducted for patients with breast cancer who underwent R-NSM or C-NSM with immediate gel implant breast reconstruction (IGBR) from July 2011 to September 2019 at a single institution to compare the clinical outcomes, patient-reported esthetic results, and medical cost. RESULTS: According to the study design, 54 procedures of R-NSM were compared with 62 procedures of C-NSM in the surgical management of breast cancer combined with IGBR. Compared with C-NSM, R-NSM was associated with higher overall satisfaction (92% excellent and 8% good versus 75.6% excellent and 24.4% good, P = 0.046), and wound/scar related outcome in patient-reported esthetic results. The NACischemia/necrosis risk, overall complication rate, and blood loss were not significantly different between R-NSM and C-NSM groups. However, longer operation time and higher overall medical cost (10,877 ± 796 versus 5,702 ± 661 US Dollars, P<0.01) was observed in R-NSM group. CONCLUSION: Compared with C-NSM, R-NSM showed comparable clinical outcomes and favorable patients' satisfaction with the esthetic results, but at the price of longer operation time and higher cost.
Authors: Jiae Moon; Jeea Lee; Dong Won Lee; Hye Sun Lee; Da Jung Nam; Min Jung Kim; Na Young Kim; Hyung Seok Park Journal: Int J Med Sci Date: 2021-04-17 Impact factor: 3.738
Authors: Min Jeong Lee; Jongmin Won; Seung Yong Song; Hyung Seok Park; Jee Ye Kim; Hye Jung Shin; Young In Kwon; Dong Won Lee; Na Young Kim Journal: Front Oncol Date: 2022-09-14 Impact factor: 5.738