单孔乳腔镜辅助胸肌前假体置入对比开放胸肌后假体置入Ⅰ期乳房重建术的回顾性研究
袁帅负责翻译和总结、撰稿，徐国萍负责文献查阅，杨莉、史有阳负责整理数据和汇总，魏敏负责指导、审查和修订。所有作者均阅读并确认最终稿。
收稿日期: 2025-02-19
网络出版日期: 2026-03-18
基金资助
国家自然科学青年基金(82205114)
Single-port breast endoscopy-assisted prepectoral implant placement versus open subpectoral implant placement in stage Ⅰ breast reconstruction: a retrospective study
Received date: 2025-02-19
Online published: 2026-03-18
目的：比较单孔乳腔镜辅助胸肌前假体置入Ⅰ期乳房重建术与传统开放胸肌后假体置入Ⅰ期乳房重建术在治疗早期乳腺癌的安全性和美观度的差异。方法：通过回顾性研究分析本院于2024年1月1日至2024年12月31日收治的早期乳腺癌乳房重建病人的临床资料。按照手术方式分为腔镜手术组10例，传统（开放）手术组14例。比较两组的手术时间、术中出血量、前哨淋巴结检出数、住院时间、术后第3天引流量、引流管拔除时间、术者对美容结局的评价（Ueda评分）、病人对乳房重建的满意度（BREAST-Q量表）等。结果：传统手术组术后引流管拔除时间晚于腔镜手术组，差异有统计学意义（P<0.05）；腔镜手术组术后美容结局（Ueda评分、BREAST-Q量表）评价优于传统手术组，差异有统计学意义（P<0.05）。两组手术时间、术中出血量、前哨淋巴结检出数、住院时间、术后第3天切口引流量对比，差异均无统计学意义（P>0.05）。结论：单孔乳腔镜辅助胸肌前假体置入Ⅰ期乳房重建术治疗乳腺癌安全性与传统开放手术组相当，但术后美学效果明显提高。该术式在严格把握临床适应证的前提下值得进一步推广。
袁帅 , 徐国萍 , 杨莉 , 史有阳 , 魏敏 . 单孔乳腔镜辅助胸肌前假体置入对比开放胸肌后假体置入Ⅰ期乳房重建术的回顾性研究[J]. 外科理论与实践, 2026 , 31(03) : 250 -256 . DOI: 10.16139/j.1007-9610.2026.03.11
Objective To assess safety and aesthetic outcomes of single-port breast endoscopy-assisted versus traditional open subpectoral implant placement in stage Ⅰ breast reconstruction for early-stage breast cancer. Methods A retrospective review was performed on clinical data from patients with early-stage breast cancer who underwent breast reconstruction at our hospital between January 1 and December 31, 2024. Patients were divided into two groups according to the surgical approach: the endoscopic surgery group (n=10) and the traditional open surgery group (n=14). Comparisons were made between groups of operation time, intraoperative blood loss, number of sentinel lymph nodes detected, length of hospital stay, wound drainage volume on postoperative day 3, drain removal time, surgeons' assessments of aesthetic outcomes (Ueda score), and patients’ satisfaction with breast reconstruction (BREAST-Q questionnaire). Statistical analyses were conducted. Results The traditional surgery group had a significantly longer postoperative drain removal time compared with the endoscopic surgery group (P<0.05). Postoperative aesthetic outcomes, evaluated by Ueda score and BREAST-Q questionnaire, were significantly superior in the endoscopic surgery group (P<0.05). No significant differences were identified between groups in operation time, intraoperative blood loss, number of sentinel lymph nodes detected, length of hospital stay, or wound drainage volume on postoperative day 3 (P>0.05). Conclusions Single-port endoscopy-assisted prepectoral implant placement in phase Ⅰ breast reconstruction appears to provide safety outcomes comparable to those of traditional open surgery, with the added benefit of improved postoperative aesthetics. Further studies are warranted to confirm its broader applicability under appropriate clinical indications.
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