Recent research from the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) indicates that breast cancer is the most prevalent malignant tumor among women, posing a significant threat to women's health. Surgery remains the primary therapeutic modality for breast cancer. Recently, endoscopic and robotic breast surgical techniques have gained acceptance among both surgeons and patients. However, considerable variation exists in surgical approaches and outcomes. To standardize these techniques, facilitate their broader clinical adoption, and ultimately improve patient care, the Endoscopic-robotic Breast Surgery Clinical Trials Consortium (ErBSCTC) of China has developed this guideline. This document encompasses the technologies and instrumentation utilized in endoscopic and robotic breast surgery, surgical techniques, perioperative management, complication handling, long-term follow-up, and oncologic outcomes, aiming to provide evidence-based guidance for healthcare professionals involved in the prevention, diagnosis, and treatment of breast diseases.
This guideline, presented in three parts, details the core aspects of endoscopic/robotic breast surgery, including its techniques, equipment, surgical procedures, perioperative management, complication treatment, long-term follow-up, and outcomes. Part one offered a comprehensive overview of indications for endoscopic and robotic breast surgery, intraoperative techniques, surgical instrument choices, and common endoscopic and robotic breast reconstruction procedures. This part will cover other endoscopic breast procedures beyond immediate breast reconstruction and include perioperative management strategies, to provide healthcare professionals involved in endoscopic and robotic breast surgery with systematic operational guidelines and clinical decision-making references.
This section systematically outlines methods for managing postoperative complications and evaluating long-term outcomes of endoscopic/robotic breast surgery (E/R-BS) to promote the standardized use of this technology and ensure optimal results. Using the Delphi method, 36 recommendations were formulated, covering eight areas: (1) management of postoperative hemorrhage after E/R-BS; (2) infection following endoscopic/robotic implant-based breast reconstruction (E/R-IBBR); (3) flap/nipple ischemia and necrosis after E/R-IBBR; (4) other complications of E/R-IBBR; (5) surgical safety of E/R-BS; (6) oncologic safety of E/R-BS; (7) aesthetic outcomes and quality of life after E/R-BS; (8) postoperative follow-up after E/R-BS.