Results
1.Basic Surgical Data:
All 52 eligible patients in this group underwent single-port axillary endoscopic sub-glandular gland resection, immediate implant-based breast reconstruction, and sentinel lymph node biopsy. Axillary lymph node dissection was performed as needed based on the patient’s condition, and stage I implant-based reconstruction was performed under endoscopy. The surgical duration ranged from 55 to 259 minutes, with an average of 168.10 minutes. Intraoperative bleeding volume ranged from 20 to 200 mL, with an average of 80 mL. The postoperative hospital stay was 2 to 4 days, with an average drain output of 120 mL on the first day and 90 mL on the second day. The total drain output over 2 days had an average of 235 mL.
2.Postoperative Complications and Follow-up
There were 8 cases of postoperative complications (15.38%), including 7 cases of incision infection, 5 cases of incision dehiscence, and 2 cases of skin flap necrosis. Two patients experienced local flap ischemic necrosis, with one patient recovering well after debridement and suturing, while the other patient had the implant removed due to radiation dermatitis 5 months after radiotherapy. Of the 7 patients with incision infection, 3 had a simple infection and recovered after local drainage and antibiotic treatment, while the other 4 cases were complicated with skin flap necrosis or incision dehiscence and required further debridement and suturing. One of these patients had good incision healing, while the other patient had poor infection control and had the implant removed. All 52 patients were followed up for 3 months postoperatively without any events such as recurrence, metastasis, or death. The average BREAST-Q score (out of 100) for the 52 patients at 3 months postoperatively were as follows: breast satisfaction, 71.40 points; sexual satisfaction, 75.61 points; social and psychological well-being, 71.99 points; physical well-being, 77.55 points, and satisfaction with medical services, 75.67 points. The score for patients with complications was significantly lower than that of patients without complications. Patients with higher drain output were more likely to develop incision infection (Tables 2-1, 2-2, and 2-3). The incidence of skin flap necrosis and incision dehiscence was not related to whether or not pressure dressing was applied postoperatively or the TNM stage (Tables 3 and 4). The incidence of incision infection was related to the application of pressure dressing and regional lymph node metastasis (Table 5). The score for breast satisfaction was not related to the TNM stage (Table 6).