中国腔镜乳腺癌手术20年回顾与展望

Twenty years of endoscopic surgery for breast cancer in China: review and prospect

经过20余年的探索和发展,中国乳腺外科已突破无腔隙器官腔镜手术的技术瓶颈,腔镜辅助乳腺癌手术发展进入高位平台期。《中国乳腺外科临床实践指南(2021版)》为手术适应证和关键技术提出宏观和谨慎的推荐意见。目前,腔镜乳腺癌手术的长期肿瘤安全性、手术入路等关键问题尚存争议,非溶脂法经腋窝切口单孔腔镜乳腺癌手术具有良好的发展趋势。2023年,“早期乳腺癌腔镜辅助对比开放手术实施保留乳头乳晕皮下腺体切除术+同期假体重建多中心前瞻性队列研究”(CSBrS-018研究)即将启动。该研究结论有望为腔镜早期乳腺癌手术的临床价值提供高级别循证医学证据,并推动腔镜乳腺癌手术的规范化和同质化进程。

After 20 years of exploration and development,Chinese breast surgeons have overcome the difficulties and developmental bottlenecks of endoscopic surgery in noncavity organs, and endoscopy-assisted breast surgery for breast cancer has entered the high platform period. Chinese Society of Breast Surgery(CSBrS) Practice Guideline 2021provides macro and cautious recommendations for surgical indications and key techniques. Although several key, issues such as long-term tumor safety and surgical access of endoscopy-assisted breast surgery for breast cancer are still controversial, a single-axillary-incision endoscopic-assisted hybrid technique for nipple-sparing mastectomy shows a good development trend. Chinese society of breast surgery(CSBrS)-018 is about to launch in 2023, which is expected to provide high-level evidence-based evidence on the clinical value of endoscopic surgery for early-stage breast cancer, thus promoting the standardization of surgery techniques.