Robotic- Versus Endoscopic-Assisted Nipple-Sparing Mastectomy with Immediate Prosthesis Breast Reconstruction in the Management of Breast Cancer: A Case-Control Comparison Study with Analysis of Clinical Outcomes, Learning Curve, Patient-Reported Aesthetic Results, and Medical Cost

doi:10.1245/s10434-020-08223-0

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24854

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/24854

Title:	Robotic- Versus Endoscopic-Assisted Nipple-Sparing Mastectomy with Immediate Prosthesis Breast Reconstruction in the Management of Breast Cancer: A Case-Control Comparison Study with Analysis of Clinical Outcomes, Learning Curve, Patient-Reported Aesthetic Results, and Medical Cost
Authors:	Lai, HW;Chen, ST;Tai, CM;Lin, SL;Lin, YJ;Huang, RH;Mok, CW;Chen, DR;Kuo, SJ
Date:	2020
Issue Date:	2022-08-09T08:09:04Z (UTC)
Publisher:	SPRINGER
ISSN:	1068-9265
Abstract:	Background New surgical innovations of nipple-sparing mastectomy (NSM), such as endoscopic NSM (E-NSM) or robotic NSM (R-NSM), were emerging. However, there was a lack of evidence comparing the effectiveness and safety in the management of breast cancer. Methods A case-control comparison study was conducted for patients with breast cancer underwent E-NSM or R-NSM with immediate prosthesis breast reconstruction (IPBR) from July 2010 to February 2019 at a single institution to compare the clinical outcomes, learning curve, patient-reported cosmetic results, and medical cost. Results A total of 91 E-NSM and 40 R-NSM procedures were retrieved and analyzed. The surgical margin involvement rate in both R-NSM (2.5%) and E-NSM (4.4%) procedures were relatively low (P = 0.52). The R-NSM group was associated with higher satisfaction rates in terms of scar appearance, scar length, and surgical wound position compared with the E-NSM group. Compared with E-NSM, the R-NSM operation time took longer (241 +/- 61 vs. 215 +/- 70 min, P = 0.01), less blood loss (32 +/- 29 vs. 79 +/- 62 ml, P < 0.01), and higher medical cost (10,587 +/- 554 vs. 6855 +/- 936 U.S. dollars, P < 0.01). There was no statistically significant difference in nipple ischemia/necrosis or overall complication between R-NSM and E-NSM. In the learning curve analysis, it took the 27th procedure in E-NSM and 10th procedure in R-NSM to decrease operation time significantly. Conclusions R-NSM was associated with higher wound-related satisfaction, lesser blood loss, and shorter learning curve compared with E-NSM, however, at the price of longer operation time and higher medical cost.
URI:	http://dx.doi.org/10.1245/s10434-020-08223-0 https://www.webofscience.com/wos/woscc/full-record/WOS:000517438900002 https://ir.csmu.edu.tw:8080/handle/310902500/24854
Relation:	ANNALS OF SURGICAL ONCOLOGY ,2020 ,v27 ,issue 7 ,p2255-2268
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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