BACKGROUND: Several studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM). METHODS: We analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost. RESULTS: We analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI>=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient's satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI >=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period.
BACKGROUND: Several studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM). METHODS: We analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost. RESULTS: We analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI>=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient's satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI >=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period.
Authors: Cindy H Wei; Amie M Scott; Alison N Price; Helen Catherine Miller; Anne F Klassen; Sabrina M Jhanwar; Babak J Mehrara; Joseph J Disa; Colleen McCarthy; Evan Matros; Peter G Cordeiro; Virgilio Sacchini; Andrea L Pusic Journal: Breast J Date: 2016 Jan-Feb Impact factor: 2.431
Authors: J Dauplat; F Kwiatkowski; P Rouanet; E Delay; K Clough; J L Verhaeghe; I Raoust; G Houvenaeghel; P Lemasurier; E Thivat; C Pomel Journal: Br J Surg Date: 2017-04-12 Impact factor: 6.939
Authors: Mustafa Tukenmez; Burcu Celet Ozden; Orhan Agcaoglu; Mustafa Kecer; Vahit Ozmen; Mahmut Muslumanoglu; Abdullah Igci Journal: J Laparoendosc Adv Surg Tech A Date: 2014-01-08 Impact factor: 1.878
Authors: David N Krag; Stewart J Anderson; Thomas B Julian; Ann M Brown; Seth P Harlow; Joseph P Costantino; Takamaru Ashikaga; Donald L Weaver; Eleftherios P Mamounas; Lynne M Jalovec; Thomas G Frazier; R Dirk Noyes; André Robidoux; Hugh Mc Scarth; Norman Wolmark Journal: Lancet Oncol Date: 2010-10 Impact factor: 41.316
Authors: Bruna S Mota; Rachel Riera; Marcos Desidério Ricci; Jessica Barrett; Tiago B de Castria; Álvaro N Atallah; Jose Luiz B Bevilacqua Journal: Cochrane Database Syst Rev Date: 2016-11-29
Authors: Hyung Seok Park; Joo Heung Kim; Dong Won Lee; Seung Yong Song; Seho Park; Seung Il Kim; Dae Hyun Ryu; Young Up Cho Journal: J Breast Cancer Date: 2018-09-20 Impact factor: 3.588