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与传统改良根治术相比,内镜手术对早期乳腺癌患者生活质量和临床预后的影响。

Effect of endoscopic surgery on quality of life and clinical prognosis of patients with early breast cancer compared with traditional modified radical surgery.

作者信息

Zhu Muyu, Liu Xiaoan

机构信息

Department of Breast Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.

出版信息

World J Surg Oncol. 2025 Jun 4;23(1):217. doi: 10.1186/s12957-025-03870-7.

Abstract

BACKGROUND

Breast cancer is one of the most common malignant tumors found in women. Plastic endoscopic surgery is a new surgical procedure that incorporates treatment for the tumor followed by breast reconstruction. The goal of this study was to compare the effectiveness of plastic endoscopic surgery vs. traditional procedures (modified radical surgery) regarding the quality of life and clinical prognosis for patients with early-stage breast cancer.

METHODS

Patients were divided into two groups depending on their surgical type. One group was the endoscopic group, which consisted of patients who had plastic endoscopic surgery (the patients with breast conservation needs included only tumors that were adequate for endoscopic surgery); the other was the traditional group, which consisted of patients who underwent traditional modified radical surgery (patients with no breast conservation needs, or were unsuitable for breast-conserving surgery due to a tumor or breast shape).

RESULTS

Among the 66 patients in the endoscopic group, 3 were lost to follow-up, while 2 out of the 52 participants were lost to follow-up in the traditional group. The operative time was longer in the endoscopic group versus the traditional group; however, intra-operative blood loss, duration of drainage, drainage volume, and length of incision were all significantly lower in the endoscopic group (P < 0.05). Repeated measures ANOVA revealed statistically significant differences in FACT-B scores across time between groups (P < 0.05). Pairwise comparisons indicated that FACT-B scores improved over time from measures taken before surgery to measures taken after surgery (P < 0.05). There were no significant differences between groups regarding local recurrence, distant metastasis, or mortality at 1, 2, or 3 years on follow-up (P > 0.05). The endoscopic group had a significantly lower rate of short-term complications than the traditional group (P < 0.05).

CONCLUSION

Endoscopic plastic surgery is a safe and effective treatment alternative for eligible patients seeking breast-conserving surgery, especially concerning improving perioperative outcomes and reducing short-term complications. However, as with any surgical approach, an individualized surgical approach must be made considering patient characteristics.

摘要

背景

乳腺癌是女性中最常见的恶性肿瘤之一。整形内镜手术是一种新的外科手术,包括肿瘤治疗及随后的乳房重建。本研究的目的是比较整形内镜手术与传统手术(改良根治术)对早期乳腺癌患者生活质量和临床预后的有效性。

方法

根据手术类型将患者分为两组。一组为内镜组,由接受整形内镜手术的患者组成(有保乳需求的患者仅包括适合内镜手术的肿瘤);另一组为传统组,由接受传统改良根治术的患者组成(无保乳需求的患者,或因肿瘤或乳房形状不适合保乳手术的患者)。

结果

内镜组66例患者中,3例失访,而传统组52例参与者中有2例失访。内镜组的手术时间比传统组长;然而,内镜组的术中出血量、引流时间、引流量和切口长度均显著更低(P < 0.05)。重复测量方差分析显示,两组间FACT - B评分随时间的变化有统计学显著差异(P < 0.05)。两两比较表明,FACT - B评分从术前测量到术后测量随时间有所改善(P < 0.05)。随访1年、2年或3年时,两组在局部复发、远处转移或死亡率方面无显著差异(P > 0.05)。内镜组的短期并发症发生率显著低于传统组(P < 0.05)。

结论

对于寻求保乳手术的合适患者,内镜整形手术是一种安全有效的治疗选择,尤其在改善围手术期结局和减少短期并发症方面。然而,与任何手术方法一样,必须根据患者特征制定个体化的手术方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94ba/12139050/a12191b46e22/12957_2025_3870_Fig1_HTML.jpg

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