A Meta-analysis Of The Efficacy And Safety Of Vacuum Minimally Invasive Surgery And Conventional Mastectomy In The Treatment Of Benign Breast Tumors

Objective: To systematically evaluate the clinical value of vacuum-assisted minimally invasive rotary cutting and conventional breast tumor resection in the treatment of benign breast tumors.Methods: Pub Med,Embase and Cochrane Library were searched based on related topics such as benign breast tumor,vacuum-assisted minimally invasive rotary resection and conventional breast tumor resection.Chinese database;Well-known databases,such as CNKI,Wanfang Database and Weipu Database,were screened and finally included in 33 literatures.In the literature,the observation group was treated with vacuum-assisted minimally invasive rotary cutting under the real-time monitoring of B-ultrasound,and the control group was treated with conventional breast tumor resection.A total of 20 observation indicators were summarized,including 2 general indicators(patient age,tumor diameter),7 technical feasibility indicators(operation time,intraoperative blood loss,incision length,healing days,hospitalization days,cosmetic effect,satisfaction),and 11 safety and reliability indicators(complication rate,VAS pain score on the first day after operation,moderate and severe postoperative pain rate,hematoma formation,subcutaneous ecchymosis,incision infection,pigmentation,postoperative)Results: general outcome: Compared with the control group OP,there’s no statistical significance for the age of patients and tumor diameters(P > 0.05);Results of technical feasibility: Compared with the control group OP,the observation group VAM has shorter operation time [WMD=15.82 95%CI=(-19.49,-12.15)P﹤0.05]and less blood loss [WMD=21.05 95%CI=(-24.66,-17.45)P﹤0.05],The incision was smaller [WMD=32.21 95%CI=(-52.01,-11.40)P﹤0.05],shorter healing days [WMD=-5.17 95%CI=(-8.01,-2.32)P ﹤ 0.05],shorter hospitalization days[WMD=-2.36 95%CI=(-2.95,-1.77)P﹤0.05],the cosmetic effect was better [OR=4.56 95%CI=(2.63,7.92)P ﹤ 0.05],and the satisfaction was better[OR=6.33 95%CI=(3.02,13.27)P<0.05].Safety and reliability outcome:Compared with the control group OP,the incidence of VAM complications in the observation group was lower [OR=0.25 95%CI=(0.11,0.56)P﹤0.05],and the VAS score on the first day after operation was lower [WMD=-0.80 95%CI=(-0.98,-0.62)P﹤0.05],Moderate and severe postoperative pain was less [OR=0.25 95%CI=(0.16,0.4)P﹤0.05],subcutaneous ecchymosis is less [OR=0.45 95%CI=(0.27,0.75)P﹤0.05)],and incision infection is less [OR=0.20 95%CI=(0.08,0.50)P<0.05],Pigmentation is not easy to occur[OR=0.30 95%CI=(0.12,0.75)P﹤0.05]smaller scar after operation [WMD=-19.81 95%CI=(-22.81,-16.81)P ﹤ 0.05],less breast deformation after operation [OR=0.12 95%CI=(0.08,0.24)P﹤0.05],residual tumor,postoperative recurrence and hematoma formation has no statistical significance(p > 0.05).Conclusion: Compared with conventional breast tumor resection,vacuum-assisted minimally invasive rotary resection for benign breast tumors can significantly shorten the operation time,reduce intraoperative blood loss,promote healing and postoperative recovery,reduce postoperative complications,meet patients’ needs for beautiful breasts and improve surgical satisfaction,which has clinical value.