手術士の長所と非触覚性病変の乳房保存手術における業績:多センター研究から得られた証拠
Fabio Corsi1, Maria Luisa Gasparri2, Sara Albasini3
1Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
Breast (Edinburgh, Scotland)
|February 14, 2026
まとめ
外科医の年長は,非触覚性病変の乳房保存手術 (BCS) の結果に有意な影響を与えない. 放射線誘導によるオカルト・レージオン・ローカライゼーション (ROLL) や磁性シード・ローカライゼーション (MSL) のような高度なローカライゼーション技術は,腫瘍学的安全性を確保し,BCSにおける研修生の関与をサポートします.
科学分野:
- 腫瘍学 腫瘍学
- 外科腫瘍学外科腫瘍学
- 乳房外科手術について
背景:
- 触覚不可能な病変に対する乳房保存手術 (BCS) は,しばしば外科研修生を含むユニークな課題を提示します.
- 触覚不可能な病変のBCS結果に対する外科医の長年の影響を評価することは,訓練と患者の安全にとって極めて重要です.
研究 の 目的:
- 非触覚可能な乳房病変のBCSにおける外科医の年長が手術のパフォーマンスと腫瘍学的結果に及ぼす影響を調査する.
- 外科医の経験に基づいて,異なる局所化テクニック (ワイヤーガイド,ROLL,MSL,CL) の有効性を比較する.
主な方法:
- 非触覚可能な病変のためにBCSを受けた3,195人の患者 (2016-2024) の遡及的マルチセンター分析 (LOCALIZATION01研究).
- 分析されたアウトカム: マージン状態,計算された切除比率 (CRR),手術時間,合併症.
- 外科医の長所 (主治医 vs 住院) による分層化とローカライゼーションテクニック.
主要な成果:
- 局所化技術における外科医と住人の間では,マージンポジティビティ率の有意な差は観察されなかった.
- レジデントは,ROLLでより良いCRRを示したが,特にセンチネルリンパ節生検 (SLNB) で,より長い手術時間を経験した.
- 合併症の発生率は低く,外科医とレジデントの間で比較可能でした.
結論:
- 外科医の年長は,監督下で実施された場合,非触覚性病変のBCSにおけるマージン状態,合併症率,または腫瘍学的安全性に大きな影響を与えない.
- ROLLやMSLのような再現可能な局所化技術は,外科的な未経験の影響を軽減することができます.
- 発見は,適切な監督でBCS手順に外科研修生を安全に統合することを支持しています.
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