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Meta-Analysis
. 2022 Apr;16(2):265-272.
doi: 10.1007/s11701-021-01265-w. Epub 2021 Jun 14.

Robotic nipple-sparing mastectomy complication rate compared to traditional nipple-sparing mastectomy: a systematic review and meta-analysis

M D Filipe  1 , E de Bock  2 , E L Postma  3 , O W Bastian  2 , P P A Schellekens  4 , M R Vriens  2 , A J Witkamp  2 , M C Richir  2
Affiliations
Meta-Analysis

Robotic nipple-sparing mastectomy complication rate compared to traditional nipple-sparing mastectomy: a systematic review and meta-analysis

M D Filipe et al. J Robot Surg. 2022 Apr.

Abstract

Breast cancer is worldwide the most common cause of cancer in women and causes the second most common cancer-related death. Nipple-sparing mastectomy (NSM) is commonly used in therapeutic and prophylactic settings. Furthermore, (preventive) mastectomies are, besides complications, also associated with psychological and cosmetic consequences. Robotic NSM (RNSM) allows for better visualization of the planes and reducing the invasiveness. The aim of this study was to compare the postoperative complication rate of RNSM to NSM. A systematic search was performed on all (R)NSM articles. The primary outcome was determining the overall postoperative complication rate of traditional NSM and RNSM. Secondary outcomes were comparing the specific postoperative complication rates: implant loss, hematoma, (flap)necrosis, infection, and seroma. Forty-nine studies containing 13,886 cases of (R)NSM were included. No statistically significant differences were found regarding postoperative complications (RNSM 3.9%, NSM 7.0%, p = 0.070), postoperative implant loss (RNSM 4.1%, NSM 3.2%, p = 0.523), hematomas (RNSM 4.3%, NSM 2.0%, p = 0.059), necrosis (RNSM 4.3%, NSM 7.4%, p = 0.230), infection (RNSM 8.3%, NSM 4.0%, p = 0.054) or seromas (RNSM 3.0%, NSM 2.0%, p = 0.421). Overall, there are no statistically significant differences in complication rates between NSM and RNSM.

Keywords: Minimally invassive; Robot assisted nipple sparing mastectomy; Surgery.

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Conflict of interest statement

M.D. Filipe, E. de Bock, E.L. Postma, O.W. Bastian declares, P.P.A. Schellekens, M.R. Vriens, A.J. Witkamp and M.C. Richir declare that they have no conflict of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Flow chart showing literature search and study selection with 49 relevant studies ultimately enrolled in this meta-analysis on the complication rate of (robotic) nipple-sparing mastectomy
Fig. 2
Fig. 2
Complication rates. (R)NSM (robotic) nipple-sparing mastectomy, CI confidence interval
Fig. 3
Fig. 3
Summary of the risks of bias and applicability domains. D1 = Bias due to confounding D2 = Bias in selection of participants into the study; D3 = Bias in the classification of interventions; D4 = Bias due to deviations from intended interventions; D5 = Bias due to missing data; D6 = Bias in measurements of outcomes; D7 = Bias in the selection of the reported result
See this image and copyright information in PMC

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