Gilles Houvenaeghel1, Houssein El Hajj2, Andy Schmitt3, Monique Cohen4, Sandrine Rua5, Julien Barrou6, Eric Lambaudie7, Marie Bannier8. 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. Electronic address: houssein-elhajj@outlook.com. 3. Department of Surgical Oncology, Paoli Calmettes Institute, 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: andy.schmitt27@gmail.com. 4. Department of Surgical Oncology, Paoli Calmettes Institute, 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: cohenm@ipc.unicancer.fr. 5. Department of Surgical Oncology, Paoli Calmettes Institute, 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: ruas@ipc.unicancer.fr. 6. Department of Surgical Oncology, Paoli Calmettes Institute, 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: barrouj@ipc.unicancer.fr. 7. Department of Surgical Oncology, Paoli Calmettes Institute and CRCM, CNRS, INSERM, Aix Marseille Université., 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: lambaudiee@ipc.unicancer.fr. 8. Department of Surgical Oncology, Paoli Calmettes Institute, 232 Bd de Sainte Marguerite, 13009, Marseille, France. Electronic address: bannierm@ipc.unicancer.fr.
Abstract
INTRODUCTION: Breast reconstruction is an essential part of breast cancer treatment. After skin sparing mastectomy, Immediate Breast Reconstruction (IBR) can be achieved using breast implants, autologous flaps (i.e. latissimus dorsi-myo-cutaneous flap (LDF)) or an association of both. Robotic assistance has gained popularity in many surgical fields including breast surgery. This study aims to compare the post-operative results of Robotic Assisted Latissimus Dorsi Flap (RALDF) to Traditional Latissimus Dorsi Flap (TLDF) for IBR after Skin Sparing Mastectomy (SSM) without nipple conservation. MATERIALS AND METHODS: Between March 2016 and June 2019, all patients who underwent a SSM and a concurrent IBR with a TLDF were retrospectively compared to patients who underwent SSM and a concurrent IBR with a RALDF. Outcomes compared included operative time, length of hospital stay and complications rate. RESULTS: 105 cases of SSM with a LDF based IBR were included in the study. 46 patients underwent RALDF and 59 patients underwent TLDF. Mean operative time was longer in the RALDF group (290.5min versus 259.7min). In binary regression, the concomitant placement of breast implant was the only factor associated with an operative time exceeding 290 min (p = 0.032). Univariate analysis showed no significant difference concerning the rate of complications (p = 0.061). After logistic regression, RALDF was associated with a decreased rate of complications (p = 0.042; OR 0.37; IC 95% (0.142-0.966)). DISCUSSION: SSM with IBR using RALDF is an effective and safe technique. This technique is actually associated with a lower complication rate at the expense of a longer operative time.
INTRODUCTION: Breast reconstruction is an essential part of breast cancer treatment. After skin sparing mastectomy, Immediate Breast Reconstruction (IBR) can be achieved using breast implants, autologous flaps (i.e. latissimus dorsi-myo-cutaneous flap (LDF)) or an association of both. Robotic assistance has gained popularity in many surgical fields including breast surgery. This study aims to compare the post-operative results of Robotic Assisted Latissimus Dorsi Flap (RALDF) to Traditional Latissimus Dorsi Flap (TLDF) for IBR after Skin Sparing Mastectomy (SSM) without nipple conservation. MATERIALS AND METHODS: Between March 2016 and June 2019, all patients who underwent a SSM and a concurrent IBR with a TLDF were retrospectively compared to patients who underwent SSM and a concurrent IBR with a RALDF. Outcomes compared included operative time, length of hospital stay and complications rate. RESULTS: 105 cases of SSM with a LDF based IBR were included in the study. 46 patients underwent RALDF and 59 patients underwent TLDF. Mean operative time was longer in the RALDF group (290.5min versus 259.7min). In binary regression, the concomitant placement of breast implant was the only factor associated with an operative time exceeding 290 min (p = 0.032). Univariate analysis showed no significant difference concerning the rate of complications (p = 0.061). After logistic regression, RALDF was associated with a decreased rate of complications (p = 0.042; OR 0.37; IC 95% (0.142-0.966)). DISCUSSION: SSM with IBR using RALDF is an effective and safe technique. This technique is actually associated with a lower complication rate at the expense of a longer operative time.