5008 ORAL Long Term Results of Video-assisted Breast Surgery (VABS)

Introduction Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the long-term cosmetic results of the two methods. This paper compares the long-term cosmetic results of the two methods, based on follow-up assessments. Methods Between 2004 and 2011, 143 preselected patients underwent a MIVAT in our department. Additionally, 134 patients underwent a conventional thyroidectomy in our hospital in 2011. A total of 117 patients from the MIVAT group and 102 patients from the conventional thyroidectomy group received follow-up assessments after 23.1 and 23.6 months, respectively, using the patient and observer scar assessment scale. Results The measurable cervical scar length averaged 1.9 cm in the MIVAT group and 3.9 cm in the conventional group (P < 0.001). Some 11.1% of the patients in the MIVAT group and 7.1% of the patients in the conventional group had developed keloid (P = 0.391). The patient scar assessment score was 10.4 for the MIVAT group compared with 9.9 for the conventional thyroidectomy group (P = 0.691) and the observer scare assessment score was 8.6 for MIVAT compared with 9.9 for conventional thyroidectomy (P = 0.011). Conclusion In the patient assessment instrument, conventional thyroidectomy had a small advantage over MIVAT in the cosmetic long-term results. This difference between the two groups was, however, not significant. Our result contradicts short-term cosmetic results of published randomized studies with improvement for MIVAT. The Observer Score demonstrates a significant advantage of the MIVAT.

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Video-Assisted Minimally Invasive Parathyroidectomy: Benefits and Long-Term Results

World Journal of Surgery ◽

10.1007/s00268-009-9931-7 ◽

2009 ◽

Vol 33 (11) ◽

pp. 2266-2281 ◽

Cited By ~ 25

Author(s):

Celestino P. Lombardi ◽

Marco Raffaelli ◽

Emanuela Traini ◽

Carmela De Crea ◽

Salvatore M. Corsello ◽

...

Keyword(s):

Minimally Invasive ◽

Minimally Invasive Parathyroidectomy ◽

Long Term Results ◽

Invasive Parathyroidectomy ◽

Video Assisted

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Video-assisted thoracoscopic surgery management of spontaneous pneumothorax — long-term results

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2010.10.012 ◽

2011 ◽

Vol 40 (1) ◽

pp. 120-123 ◽

Cited By ~ 32

Author(s):

Kasra Shaikhrezai ◽

Alexandra I. Thompson ◽

Caroline Parkin ◽

Steven Stamenkovic ◽

William S. Walker

Keyword(s):

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Long Term Results ◽

Video Assisted ◽

Surgery Management ◽

Video Assisted Thoracoscopic Surgery

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Comparison of long-term results of endoscopic video-assisted breast surgery (VABS) between transaxillary retromammary approach (TARM) and periareolar approach.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1112 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1112-1112

Author(s):

Koji Yamashita ◽

Shunsuke Haga ◽

Kazuo Shimizu

Keyword(s):

Breast Surgery ◽

Surgical Margin ◽

Distant Metastases ◽

Skin Incision ◽

Long Term Results ◽

Breast Diseases ◽

Breast Cancers ◽

Great Satisfaction ◽

Video Assisted ◽

Aesthetic Results

1112 Background: The breast conserving surgery (BCS) and the sentinel node (SN) biopsy became to be recognized as the standard treatment for early breast cancers. We have reported about cosmetic effectiveness and lower infestation of the video-assisted breast surgery (VABS) for the breast diseases. We devised the trans-axillary retro-mammary (TRAM) approach of VABS. It needs only one skin incision in the axilla and can treat any tumor of the breast without making any injuries on the breast skin. We evaluated the aesthetic results and the curability of this surgical method. Methods: We have performed VABS on 300 patients since December, 2001. The newly devised TARM was performed on 120 patients of early breast cancer, stage I and II. After endoscopic SN biopsy, we elongated the axillary skin incision to 2.5 cm. We dissected major pectoral muscle fascia to detach retromammary tissue behind the tumor. We cut the mammary gland with clear surgical margin, and removed it through the axillary port. The breast reconstruction was made by filling absorbable oxydized cellulose. The postoperative aesthetic results were evaluated by ABNSW. Results: BCS was performed on 286 patients (26 after preoperative chemotherapy) and skin-sparing mastectomy on 14. There was no serious complication after surgery. Surgical margin was minimally positive in 2. The original shapes of the breast were preserved well. The follow-up is 126 months at maximum and 74 months on average. There is 3 locoregional recurrences and 14 distant metastases. 5-year survival rate is 97.3%. With regard to TARM, The skin incision only in the axilla made better looks and shapes of the breast. It could be applied for tumors in any area of the breast without tumor nipple extension. The reconstruction with oxidized cellulose needs no excessive detachment of the skin beyond the surgical margin. The postoperative esthetic results were excellent and better. The sensory disturbance was minimal. All patients expressed great satisfaction. Conclusions: VABS can be considered as a good surgical procedure concerning locoregional control and esthetics. TARM is better on the patients without tumor nipple extension.

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