Skip to main content

Advertisement

SpringerLink
Log in

Endoscopic-Assisted Trans-lateral Thoracic Single-Port Nonliposuction Immediate Prosthesis Combined with Titanium Mesh Breast Reconstruction for Early Breast Cancer: a Single-Centre, Small-Sample, Summary Report of a New Surgery

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The objective of this study is to evaluate the clinical outcomes of endoscopic-assisted trans-lateral thoracic single-port nonliposuction immediate prosthesis combined with titanium mesh breast reconstruction (IPMBR) after nipple-sparing mastectomy (NSM) for early breast cancer (EBC). The clinicopathological data of 51 patients with EBC who underwent NSM and IPMBR via lateral thoracotomy using a single-port nonliposuction endoscopic technique between February 2020 and February 2023 were collected and analysed to determine the success rate, operative time, intraoperative conditions, postoperative complications, and oncological safety of the procedure and the cosmetic outcome of reconstructed breast. The surgery was successful in all the patients, with a 100% success rate (51/51). There were differences in the operative time (minutes), intraoperative bleeding volume, postoperative drainage volume, and length of hospital stay between the first-year group and the one-year later group (P<0.05), but there was no difference in the extubation time, hospital costs, or incidence of postoperative complications between the two groups (P>0.05). At 6 months after surgery, there was a difference in the excellent rate between the breast reconstruction patients who underwent radiotherapy and those who did not (86.67% vs. 13.33%, χ2=7.291, P=0.007). However, there was no difference in the excellent rate between the first-year group and the one-year later group (χ2=1.093, P=0.296). Fifty-one patients were followed up for a mean of 14.8 months, and there was no recurrence or distant metastasis. Endoscopic-assisted translateral thoracic uniportal nonliposuction IPMBR is a new clinically feasible technique that has a high success rate, few postoperative complications, good aesthetic outcomes of the reconstructed breast (but compromised by postoperative radiotherapy), and high oncological safety. For people with EBC, this new technology is a new option.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data Availability

Each patient authorized the use of their clinical data and agreed to its public publication. The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Song G, Zhang Y (2022) Clinicopathological characteristics, treatments, and prognosis of breast ductal carcinoma in situ with microinvasion: a narrative review. Chronic Dis Transl Med 9(1):5–13. https://doi.org/10.1002/cdt3.53

    Article  PubMed  PubMed Central  Google Scholar 

  2. van de Voort EMF, Struik GM, Birnie E, Moelker A, Verhoef C, Klem TMAL (2021) Thermal ablation as an alternative for surgical resection of small (≤2 cm) breast cancers: a meta-analysis. Clin Breast Cancer 21(6):e715–e730. https://doi.org/10.1016/j.clbc.2021.03.004

    Article  PubMed  Google Scholar 

  3. Kim H, Lee SB, Nam SJ, Lee ES, Park BW, Park HY, Lee HJ, Kim J, Chung Y, Kim HJ, Ko BS, Lee JW, Son BH, Ahn SH (2021) Survival of breast-conserving surgery plus radiotherapy versus total mastectomy in early breast cancer. Ann Surg Oncol 28(9):5039–5047. https://doi.org/10.1245/s10434-021-09591-x

    Article  PubMed  Google Scholar 

  4. Guo L, Xie G, Wang R, Yang L, Sun L, Xu M, Yang W, Chung MC (2021) Local treatment for triple-negative breast cancer patients undergoing chemotherapy: breast-conserving surgery or total mastectomy? BMC Cancer 21(1):717. https://doi.org/10.1186/s12885-021-08429-9

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cha Y, Lee S (2022) Endoscopy-assisted latissimus dorsi muscle flap harvesting technique for immediate breast reconstruction. Ann Chir Plast Esthet S0294-1260(22):00171–00176. https://doi.org/10.1016/j.anplas.2022.09.004

    Article  Google Scholar 

  6. Feng Y, Wen N, Liang F, Zhou J, Qin X, Liu X, Li J, Qiu M, Yang H, Du Z (2022) Endoscopic nipple- or skin-sparing mastectomy and immediate breast reconstruction with endoscopic harvesting of the latissimus dorsi flap: a preliminary experience of an innovative technique. Breast J:1373899. https://doi.org/10.1155/2022/1373899

  7. Park HS, Lee J, Lai HW, Park JM, Ryu JM, Lee JE, Kim JY, Marrazzo E, De Scalzi AM, Corso G, Montemurro F, Gazzetta G, Pozzi G, Toesca A (2022) Surgical and oncologic outcomes of robotic and conventional nipple-sparing mastectomy with immediate reconstruction: international multicenter pooled data analysis. Ann Surg Oncol 29(11):6646–6657. https://doi.org/10.1245/s10434-022-11865-x

    Article  PubMed  Google Scholar 

  8. Bishop SN, Asaad M, Liu J, Chu CK, Clemens MW, Kapur SS, Largo RD, Selber JC (2022) Robotic harvest of the deep inferior epigastric perforator flap for breast reconstruction: a case series. Plast Reconstr Surg 149(5):1073–1077. https://doi.org/10.1097/PRS.0000000000008988

    Article  CAS  PubMed  Google Scholar 

  9. Wang ZH, Ding G, Wu S, Song JN, Ge ZC, Zhang H, Yuan Z, Gao YG, Gang TR, Zhang Z, Qu X (2022) Oncological outcome of single-port insufflation endoscopic nipple-sparing mastectomy versus open mastectomy in early breast cancer patients: a study protocol for a randomised controlled trial. BMJ Open 12(5):e047866. https://doi.org/10.1136/bmjopen-2020-047866

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ahmed YS, Abd El Maksoud WM (2022) Combined endoscopy-assisted muscle-sparing latissimus dorsi flap harvesting with lipofilling enhancement as a new volume replacement technique in breast reconstruction. Breast J 2022:7740439. https://doi.org/10.1155/2022/7740439

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hao J, Li J (2020) Guidelines of Chinese Society of Clinical Oncology (CSCO). In: Jiang ZF (ed) Breast Cancer, 2020th edn, Beijing, China, pp 25–43

  12. Yao C, Chen M, Liu C, Huang C, Xian J (2022) Application of silicone gel breast prosthesis combined with titanium polypropylene mesh in immediate breast reconstruction for early breast cancer. J Tissue Eng Regen Med 18(3):247–251. https://doi.org/10.3969/j.issn.1673-0364.2022.03.009

    Article  Google Scholar 

  13. Yao C-c, Liu C, Xian J (2023) Comparison of single-pore non-liposuction near-infrared laparoscopy with conventional open surgery for axillary sentinel lymph node biopsy in patients with early breast cancer: a single-center, small-sample retrospective study. World J Surg Oncol 21:66. https://doi.org/10.1186/s12957-023-02942-w

    Article  PubMed  PubMed Central  Google Scholar 

  14. Rose MA, Olivotto I, Cady B, Koufman C, Osteen R, Silver B, Recht A, Harris JR (1989) Conservative surgery and radiation therapy for early breast cancer. Long-term cosmetic results. Arch Surg 124(2):153–157. https://doi.org/10.1001/archsurg.1989.01410020023002

    Article  CAS  PubMed  Google Scholar 

  15. Huang L, Lin YH, Yang Y, Gong ZL, He L (2021) Comparative analysis of vaginal natural orifice transluminal endoscopic surgery versus transumbilical laparoendoscopic single-site surgery in ovarian cystectomy. J Obstet Gynaecol Res 47(2):757–764. https://doi.org/10.1111/jog.14603

    Article  PubMed  Google Scholar 

  16. Dietrich CG, Schoppmeyer K (2020) Percutaneous endoscopic gastrostomy - too often? Too late? Who are the right patients for gastrostomy? World J Gastroenterol 26(20):2464–2471. https://doi.org/10.3748/wjg.v26.i20.2464

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tsukamoto M, Imai K, Yamashita YI, Kitano Y, Okabe H, Nakagawa S, Nitta H, Chikamoto A, Ishiko T, Baba H (2020) Endoscopic hepatic resection and endoscopic radiofrequency ablation as initial treatments for hepatocellular carcinoma within the Milan criteria. Surg Today 50(4):402–412. https://doi.org/10.1007/s00595-019-01903-9

    Article  PubMed  Google Scholar 

  18. Yoshihiro G, Takagi S, Yanagisawa J, Nakasu A, Okawa Y (2021) Endoscopic internal thoracic artery harvesting with changes in scope position. Heart Surg Forum 24(6):E950–E951. https://doi.org/10.1532/hsf.4195

    Article  PubMed  Google Scholar 

  19. Kobayashi Y, Nishikawa K, Akasaka T, Kato S, Hamakawa T, Yamamoto K, Kobayashi N, Kitakaze M, Maeda S, Uemura M, Miyake M, Hama N, Miyamoto A, Kato T, Miyazaki M, Nakamori S, Mita E, Sekimoto M, Mano M, Hirao M (2021) Retrograde endoscopic submucosal dissection for early thoracic esophageal carcinoma. Clin J Gastroenterol 14(2):434–438. https://doi.org/10.1007/s12328-021-01371-0

    Article  PubMed  Google Scholar 

  20. Xie F, Wang ZH, Wu SS, Gang TR, Gao GX, Qu X, Zhang ZT (2022) Comparing outcomes of single-port insufflation endoscopic breast-conserving surgery and conventional open approach for breast cancer. World J Surg Oncol 20(1):335. https://doi.org/10.1186/s12957-022-02798-6

    Article  PubMed  PubMed Central  Google Scholar 

  21. Song WU, Jiaxin ZHANG (2020) Analysis of the progress in establishing operating space for laparoscopic mammary surgery. China Continuing Medical Education 12(12):114–116. https://doi.org/10.3969/j.issn.1674-9308.2020.12.048

    Article  Google Scholar 

  22. Ryu JM, Kim JY, Choi HJ, Ko B, Kim J, Cho J, Lee MH, Choi JE, Kim JH, Lee J, Jung SM, Shin HJ, Lee J, Park HS (2022) Robot-assisted nipple-sparing mastectomy with immediate breast reconstruction: an initial experience of the Korea Robot-endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG). Ann Surg 275(5):985–991. https://doi.org/10.1097/SLA.0000000000004492

    Article  PubMed  Google Scholar 

  23. Voulliaume D, Vasseur C, Delaporte T, Delay E (2003) Un risque inhabituel de la liposuccion: la liposuccion d'une tumeur maligne. A propos de 2 cas [An unusual risk of liposuction: liposuction of a malignant tumor. About 2 patients]. Ann Chir Plast Esthet 48(3):187–193. https://doi.org/10.1016/s0294-1260(03)00043-8

    Article  CAS  PubMed  Google Scholar 

  24. Shi F, Huang Z, Yu J, Zhang P, Deng J, Zou L, Zhang C, Luo Y (2017) Immediate liposuction could shorten the time for endoscopic axillary lymphadenectomy in breast cancer patients. World J Surg Oncol 15(1):35. https://doi.org/10.1186/s12957-017-1106-7

    Article  PubMed  PubMed Central  Google Scholar 

  25. Huang Z, Chen K, Zhu L, Zeng J, Zhou Z, Li S (2018) Effectiveness of endoscopic nipple-sparing mastectomy combined with immediate breast reconstruction via axillary incision. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 32(11):1458–1462. https://doi.org/10.7507/1002-1892.201804027

    Article  PubMed  Google Scholar 

  26. Lai HW, Lin SL, Chen ST, Kuok KM, Chen SL, Lin YL, Chen DR, Kuo SJ (2018) Single-axillary-incision endoscopic-assisted hybrid technique for nipple-sparing mastectomy: technique, preliminary results, and patient-reported cosmetic outcome from preliminary 50 procedures. Ann Surg Oncol 25(5):1340–1349. https://doi.org/10.1245/s10434-018-6383-z

    Article  PubMed  Google Scholar 

  27. Chen Y, Xu J, Liang Y, Zeng X, Xu S (2020) A challenging therapeutic method for breast cancer: Non-lipolytic endoscopic axillary surgery through periareolar incisions. Oncol Lett 19(6):4088–4092. https://doi.org/10.3892/ol.2020.11501

    Article  PubMed  PubMed Central  Google Scholar 

  28. Liang Y, Xu S (2020) Nonliposuction endoscopic sentinel lymph node biopsy through the periareolar incision. Surg Innov 27(6):570–579. https://doi.org/10.1177/1553350620942983

    Article  PubMed  Google Scholar 

  29. Qiu J, Wen N, Xie Y, Feng Y, Liang F, Lv Q, Du Z (2022) Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery. Gland Surg 11(8):1383–1394. https://doi.org/10.21037/gs-22-398

    Article  PubMed  PubMed Central  Google Scholar 

  30. Awadeen A, Fareed M (2023) Elameen AM (2023) The impact of postmastectomy radiation therapy on the outcomes of prepectoral implant-based breast reconstruction: a systematic review and meta-analysis. Aesthetic Plast Surg 47(1):81–91. https://doi.org/10.1007/s00266-022-03026-y

    Article  PubMed  Google Scholar 

  31. Cagli B, Morelli Coppola M, Augelli F, Segreto F, Tenna S, Cogliandro A, Persichetti P (2022) Postmastectomy radiation therapy in the setting of two-stage retropectoral implant-based breast reconstruction: should it be delivered before or after implant exchange? A retrospective analysis on 183 patients. Aesthetic Plast Surg 46(6):2643–2654. https://doi.org/10.1007/s00266-022-03001-7

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the Medical Research Program of the Foshan Health and Family Planning Commission (No. 20190260) and the Foshan High-Level Medical Talent Training Fund, China (No. 2018B015) and the Medical Science and Technology Research Project of Foshan Science and Technology Bureau (No. 2220001004005).

Author information

Authors and Affiliations

  1. Sixth Affiliated Hospital of South China University of Technology, and Sixth Clinical College of South China University of Technology, N0. 120 Guidan Road, Nanhai District, Foshan, 528225, Guangdong Province, People’s Republic of China

    Chengcai Yao

  2. Department of Breast Surgery, Sixth Affiliated Hospital of South China University of Technology, and Sixth Clinical College of South China University of Technology, Foshan, 528225, People’s Republic of China

    Changchun Liu & Wenjian Huang

Authors
  1. Chengcai Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Changchun Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wenjian Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The article was mainly written by Chengcai Yao, Changchun Liu, and Wenjian Huang, and these authors contributed equally to the study. All authors did an operation study. The whole study was instructed by Chengcai Yao. Wenjian Huang and Changchun Liu helped with data analysis and paper editing. All authors reviewed and approved the manuscript.

Corresponding author

Correspondence to Chengcai Yao.

Ethics declarations

Ethics Approval

This research study was conducted retrospectively from data obtained for clinical purposes. The Ethics Committee of our hospital approved the retrospective study (No. 2022142).

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

The authors affirm that all the participants signed informed consent forms regarding the publication of their data, photographs, and video.

Competing Interests

The authors declare no competing interests.

Additional information

I would like to declare on behalf of my co-authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

(MP4 308378 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yao, C., Liu, C. & Huang, W. Endoscopic-Assisted Trans-lateral Thoracic Single-Port Nonliposuction Immediate Prosthesis Combined with Titanium Mesh Breast Reconstruction for Early Breast Cancer: a Single-Centre, Small-Sample, Summary Report of a New Surgery. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03908-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12262-023-03908-8

Keywords

Search

Navigation