Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction
BackgroundSeveral studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM).MethodsWe analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate br...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.637049/full |
| _version_ | 1818937380503027712 |
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| author | Gilles Houvenaeghel Gilles Houvenaeghel Julien Barrou Julien Barrou Camille Jauffret Sandrine Rua Laura Sabiani Aurore Van Troy Max Buttarelli Guillaume Blache Eric Lambaudie Eric Lambaudie Monique Cohen Marie Bannier |
| author_facet | Gilles Houvenaeghel Gilles Houvenaeghel Julien Barrou Julien Barrou Camille Jauffret Sandrine Rua Laura Sabiani Aurore Van Troy Max Buttarelli Guillaume Blache Eric Lambaudie Eric Lambaudie Monique Cohen Marie Bannier |
| author_sort | Gilles Houvenaeghel |
| collection | DOAJ |
| description | BackgroundSeveral studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM).MethodsWe analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost.ResultsWe analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI>=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient’s satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI >=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period. |
| first_indexed | 2024-12-20T05:51:02Z |
| format | Article |
| id | doaj.art-8247bf40fece454e9449c5e9283a585e |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-20T05:51:02Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-8247bf40fece454e9449c5e9283a585e2022-12-21T19:51:10ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-03-011110.3389/fonc.2021.637049637049Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast ReconstructionGilles Houvenaeghel0Gilles Houvenaeghel1Julien Barrou2Julien Barrou3Camille Jauffret4Sandrine Rua5Laura Sabiani6Aurore Van Troy7Max Buttarelli8Guillaume Blache9Eric Lambaudie10Eric Lambaudie11Monique Cohen12Marie Bannier13Department of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceCRCM, CNRS, INSERM, Aix Marseille Université, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceCRCM, CNRS, INSERM, Aix Marseille Université, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceCRCM, CNRS, INSERM, Aix Marseille Université, Marseille, FranceDepartment of Surgical Oncology, Paoli Calmettes Institute, Marseille, FranceCRCM, CNRS, INSERM, Aix Marseille Université, Marseille, FranceBackgroundSeveral studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM).MethodsWe analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost.ResultsWe analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI>=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient’s satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI >=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period.https://www.frontiersin.org/articles/10.3389/fonc.2021.637049/fullnipple sparing mastectomyrobotic surgerybreast reconstructionpredictive scorebreast cancer |
| spellingShingle | Gilles Houvenaeghel Gilles Houvenaeghel Julien Barrou Julien Barrou Camille Jauffret Sandrine Rua Laura Sabiani Aurore Van Troy Max Buttarelli Guillaume Blache Eric Lambaudie Eric Lambaudie Monique Cohen Marie Bannier Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction Frontiers in Oncology nipple sparing mastectomy robotic surgery breast reconstruction predictive score breast cancer |
| title | Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction |
| title_full | Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction |
| title_fullStr | Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction |
| title_full_unstemmed | Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction |
| title_short | Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction |
| title_sort | robotic versus conventional nipple sparing mastectomy with immediate breast reconstruction |
| topic | nipple sparing mastectomy robotic surgery breast reconstruction predictive score breast cancer |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.637049/full |
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