Background: Robotic nipple-sparing mastectomy (RNSM) may allow for more precise anatomic dissection and improved cosmetic outcomes over conventional open nipple-sparing mastectomy; however, data regarding the feasibility and safety of the procedure are limited. Objective: The aim of this study was to present and discuss perioperative surgical outcomes and early oncologic follow-up data on consecutive patients undergoing RNSM from June 2014 to January 2019. Methods: Patients underwent RNSM and immediate robotic breast reconstruction through an axillary incision at a single institution. Perioperative data, complications at 3 months postoperatively, pathological data, and adjuvant therapies were recorded. Local recurrence-free, disease-free, and overall survival were analyzed. Results: Overall, 73 women underwent 94 RNSM procedures. Indications were invasive breast cancer in 39 patients, ductal carcinoma in situ in 17 patients, and BRCA mutation in 17 patients. Mean surgery time was 3 h and 32 min. One-step reconstruction with implant occurred in 89.4% of procedures. The rate of complications requiring reoperation was 4.3%, and the rate of flap or nipple necrosis was 1.1%. Median follow-up was 19 months (range 3.1–44.8). No local recurrences occurred. Overall survival at 12, 24, or 60 months was 98% (95% confidence interval 86–100%). Conclusion: We observed a low complication rate in 94 consecutive RNSM procedures, demonstrating the procedure is technically feasible and safe. We found no early local failures at 19 months follow-up. Long-term follow-up is needed to confirm oncologic safety. Future clinical trials to study the advantages and disadvantages of RNSM are warranted.
Update on the Feasibility and Progress on Robotic Breast Surgery / A. Toesca, A. Invento, G. Massari, A. Girardi, N. Peradze, G. Lissidini, C. Sangalli, P. Maisonneuve, A. Manconi, A. Gottardi, J.L. Baker, L. Bottiglieri, P. Naninato, G. Farante, F. Magnoni, A. De Scalzi, G. Corso, M. Colleoni, F. De Lorenzi, V. Sacchini, V. Galimberti, M. Intra, M. Rietjens, P. Veronesi. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1068-9265. - 26:10(2019 Oct), pp. 3046-3051.
|Titolo:||Update on the Feasibility and Progress on Robotic Breast Surgery|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||ott-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1245/s10434-019-07590-7|
|Appare nelle tipologie:||01 - Articolo su periodico|