Evaluation of Single-Port Endoscopic Nipple/Skin-Sparing Mastectomy with Prepectoral Breast Implant Reconstruction in Clinical Practice.

Abstract

Background: The objective of this study was to provide an overview of the clinical outcomes associated with single-port endoscopic nipple/skin-sparing mastectomy with total prepectoral breast implant reconstruction.

Methods: From April of 2021 to April of 2024, patients undergoing single-port endoscopic nipple/skin-sparing mastectomy with total prepectoral breast implant reconstruction were selected to evaluate the efficacy and safety of this method and to collect information on patient-reported outcomes.

Results: A total of 218 patients were enrolled in this study, 207 of whom completed follow-up, yielding a follow-up rate of 95.0%. In terms of surgical safety, the occurrence of flap ischemic problems was 7.8%, and the occurrence of flap necrosis was 3.7%. The occurrence of nipple resection during surgery was 7.4%, and among the 191 patients who had their nipples preserved, the occurrence of nipple ischemia was 7.0%. The occurrence of nipple necrosis was 1.5%, that of infection 10.1%, and that of prosthesis removal 3.9%. Approximately 1.0% of patients experienced metastasis and recurrence during the median 14.3-month follow-up period, as demonstrated by the cumulative sum curve. A cumulative plot analysis indicated that it would require approximately 21 cases for the surgeon to achieve a meaningful reduction in operating time.

Conclusions: Single-port endoscopic nipple/skin-sparing mastectomy with total prepectoral breast implant reconstruction is a safe, effective, and visually acceptable surgical technique. Although it provides good oncologic safety, further evidence is required to fully support its use.

Clinical question/level of evidence: Therapeutic, IV.