单孔腔镜辅助对比开放保乳手术的短期临床疗效的回顾性队列研究

A retrospective cohort study on the short-term clinical efficacy of single-port assisted endoscopic breast conserving surgery versus conventional open approach for breast cancer

目的对比单孔腔镜辅助保乳手术和开放保乳手术用于治疗女性乳腺癌患者的短期疗效和患者满意度。方法回顾性分析2022年3月至2023年6月期间中山大学孙逸仙纪念医院收治的129例女性乳腺癌患者的临床资料,其中56例患者接受单孔腔镜辅助保乳手术(腔镜组),73例患者接受开放保乳手术(开放组)。结果腔镜组(56例)相较于开放组(73例)手术时间[(200.0±43.2)min比(185.3±56.5)min]和术中出血量[(34.0±25.4)ml比(27.2±21.8)ml]差异无统计学意义(P>0.05);手术切口长度差异有统计学意义[(4.7±0.7)cm比(8.0±1.1)cm,P<0.05];术后肿瘤切缘阳性差异无统计学意义(3.5%比5.7%,P>0.05)。在术后并发症方面,放疗相关皮肤反应发生率差异有统计学意义(P<0.05)。腔镜组患者对术后美观度的满意度高,差异有统计学意义(73.2%比56.2%,P<0.05)。结论单孔腔镜辅助保乳手术治疗女性乳腺癌的短期临床疗效不亚于开放保乳手术,且术后美观度更高。

ObjectiveTo compare the short-term clinical efficacy and patient satisfaction of single-port assisted endoscopic breast-conserving surgery versus open approach in the treatment of female breast cancer patients.MethodsThis study retrospectively analyzed the clinical data of 129 female breast cancer patients admitted to Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University from March 2022 to June 2023.In this study,56 patients underwent breast-conserving surgery assisted by single-port endoscopy(endoscopic group)and 73 patients underwent conventional open breast-conserving surgery(conventional group).ResultsCompared to the conventional group(73 cases),the endoscopic group(56 cases)had slightly longer operation time[(200.0±43.2)min vs.(185.3±56.5)min]and intraoperative blood loss[(34.0±25.4)ml vs.(27.2±21.8)ml,P>0.05].The endoscopic group had a significantly shorter surgical incision length than the conventional group[(4.7±0.7)cm vs.(8.0±1.1)cm,P<0.05],the difference in postoperative tumor margin was not significant(endoscopic group:3.5%vs.conventional group:5.7%,P>0.05).In terms of postoperative complications,the endoscopic group had a significantly lower incidence of radiation-related skin reactions than the conventional group(P<0.05).The endoscopic group had a higher satisfaction rate in terms of postoperative aesthetics(73.2%vs.56.2%,P<0.05).ConclusionsThe short-term clinical efficacy of breast-conserving surgery for female breast cancer by single-port assisted endoscopy is not inferior to that of conventional open breast-conserving surgery,with added better cosmetic results.