背景:内窥镜辅助保乳手术(E-BCS)是10年前开发的一种用于乳腺癌治疗的方法,其潜在优势是不太明显的瘢痕形成。然而,支持其优于常规保乳手术(C-BCS)的证据尚不清楚.
目的:本研究旨在比较E-BCS和C-BCS治疗早期乳腺癌的疗效。
方法:使用Medline中的特定关键字对相关文章进行了全面搜索,Scopus,ClinicalTrials.gov,和Cochrane图书馆PubMed直到10月17日,2022年。收集在早期乳腺癌患者中比较E-BCS和C-BCS的临床试验。
结果:我们对9项研究的分析显示,E-BCS与较短的切口长度相关[平均差(MD)-6.50cm(95%CI-10.75,-2.26),p=0.003,I2=99%]和更高的化妆品评分[MD2.69(95%CI1.46,3.93),与C-BCS相比,p<0.0001,I2=93%]。然而,E-BCS的手术时间较长[MD35.95分钟(95%CI19.12,52.78),p<0.0001,I2=93%]和更大的排出量[MD62.91mL(95%CI2.55,123.27),p=0.04,I2=79%]。失血量无显著差异(p=0.06),排水持续时间(p=0.28),术后并发症(p=0.69),或局部复发(p=0.59)。
结论:我们的研究表明,与C-BCS相比,E-BCS治疗早期乳腺癌的切口长度更短,美容效果更好。然而,E-BCS需要更长的操作时间并且具有更大的排水量。需要进一步的研究来证实这些发现。
BACKGROUND: Endoscopy-assisted breast conserving surgery (E-BCS) was developed over 10 years ago as a method for breast cancer treatment with the potential advantage of less noticeable scarring. However, the evidence supporting its superiority over conventional breast conserving surgery (C-BCS) remains unclear.
OBJECTIVE: This study aims to compare the outcomes of E-BCS and C-BCS for the treatment of early breast cancer.
METHODS: A comprehensive search for relevant articles was performed using specific keywords in Medline, Scopus, ClinicalTrials.gov, and Cochrane Library PubMed up to October 17th, 2022. Clinical trials that compared E-BCS with C-BCS in early breast cancer patients were collected.
RESULTS: Our analysis of nine studies revealed that E-BCS was associated with shorter incision length [Mean Difference (MD) -6.50 cm (95% CI -10.75, -2.26), p = 0.003, I2 = 99%] and higher cosmetic score [MD 2.69 (95% CI 1.46, 3.93), p < 0.0001, I2 = 93%] compared with C-BCS. However, E-BCS had a longer operation time [MD 35.95 min (95% CI 19.12, 52.78), p < 0.0001, I2 = 93%] and greater drainage volume [MD 62.91 mL (95% CI 2.55, 123.27), p = 0.04, I2 = 79%]. There was no significant difference in blood loss volume (p = 0.06), drainage duration (p = 0.28), postoperative complications (p = 0.69), or local recurrence (p = 0.59) between the two groups.
CONCLUSIONS: Our study suggests that E-BCS offers a shorter incision length and better cosmetic outcome compared with C-BCS in the treatment of early breast cancer. However, E-BCS requires a longer operation time and has greater drainage volume. Further studies are needed to confirm these findings.