关键词: 乳腺癌, 机器人手术, 乳房重建, 假体

Abstract: To explore the clinical efficacy and safety of robotic nipple sparing mastectomy immediate breast reconstruction (RNSMIBR) with gel implant  for breast cancer via its comparison with conventional nipple sparing mastectomy immediate breast reconstruction (CNSMIBR). Methods    Clinical data of woman patients who underwent CNSMIBR (n=93) and RNSMIBR (n=107) at Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between April 2022 and April 2024 was retrospectively analyzed, including, clinicopathological characteristics, type of surgery, duration of surgery, and perioperative complications.  Results    The operation time of RNSMIBR group was higher than that of CNSMIBR group, and the difference was statistically significant ［(210.06±56.47) min vs. (165.27±35.19) min, P<0.001］. The operative time was different because of the axillary approach, but there was no significant disadvantage of robotic surgery. During the postoperative follow-up, 1 implant was removed in the CNSMIBR group due to infection and 2 implants were removed in the RNSMIBR group. Skin erythema occurred in 3 patients in the RNSMIBR group. The two groups had 3 cases of upper extremity lymphedema. The rate of positive posterior nipple margins in the 2 groups was 0, and there were no complications such as necrosis of the nipple-areola complex. Conclusion    Although current evidence is limited and follow-up time is relatively short, preliminary results suggest that RNSMIBR is comparable to conventional open surgical approaches in terms of efficacy and safety. Its learning curve is expected to become progressively shorter over time and as the number of cases increases. Therefore, RNSMIBR is expected to become an available surgical option for patients and may lead the future trend of breast surgery.

Key words: breast cancer, robotic surgery, breast reconstruction, implant