Single-port endoscopic stage Ⅱ reconstruction with breast implants after breast cancer resection in a case
Objective To observe the efficacy of single-port endoscopic stage Ⅱ reconstruction with breast implants after breast cancer resection in one patient,and to discuss the surgical safety.Methods A 34-year-old female patient was admitted with the chief complaint of"absence of the right breast,and demanding reconstruction with breast implants"in Henan Provincial People's Hospital on January 26,2024.She was performed a simple mastectomy+sentinel lymph node biopsy for right breast cancer in another hospital two years ago.The histopathology revealed high-grade intraductal carcinoma with calcification in the right breast,no cancer lesions in the nipple and button incisal margin,and no metastasis in the right sentinel lymph node.The immunohistochemistry showed the estrogen receptor(90％+),progesterone receptor(90％+),human epidermal growth factor receptor-2(1+),and Ki-67(about 10％+).The physical examination on admission showed that the right breast was absent,a transverse scar about 20 cm long was visible on the right chest wall,a diagonal scar about 5 cm long was visible on the armpit,and all the wounds healed well.The breast ultrasound,MRI and chest CT showed no obvious abnormalities.By day 3 after admission,"one-step"single-port endoscopic stage Ⅱ reconstruction with breast implants was performed via the previous axillary sentinel lymph node incision.The symptomatic support treatment was given after reconstruction including anti-infection,analgesia and stomach protection.The surgical time,intrasurgical blood loss,length of hospital stay,postsurgical infection and prosthesis exposure and other data were recorded.The outcome of breast reconstruction was assessed two weeks later.Results The reconstruction was smoothly completed in 165 min,with the intrasurgical blood loss of 5 mL and length of hospital stay of 7 d.The blood routine,liver function,renal function,and blood electrolytes by day 7 after surgery showed no significant abnormalities.There were no complications such as postsurgical infection,incision ischemic necrosis,prosthesis exposure or removal,movement deformity,chest wall pain and capsular contracture.Two weeks after surgery,the reconstructed breast was symmetrical with the healthy side,with natural shape,natural curvature of the breast and normal skin,and the patient was satisfied with the reconstructed breast and felt no obvious discomfort.Conclusion For this patient after breast cancer resection,it is safe and feasible to perform"one-step"transaxillary single-port endoscopic stage Ⅱ reconstruction with breast implants,and the effect of breast reconstruction is good.
breast canceraxillary approachsingle-port endoscopystage Ⅱ breast reconstruction
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