Abstract:
BACKGROUND:Oncoplastic breast-conserving surgery (OPBS) is a rapidly emerging field. Various oncoplastic techniques have been proposed and are increasingly adopted to facilitate breast conservation and preserve breast aesthetics. This systematic review seeks to assess the oncological and cosmetic outcomes of OPBS. MATERIALS AND METHODS:A systematic review of the literature was conducted using specific inclusion and exclusion criteria, for articles published up to July 31th, 2015. Relevant studies were identified using computerized bibliographic searches of MEDLINE database. The keywords that were used in various combinations were: "Oncoplastic surgery", "oncological results", "cosmetic results", "cosmesis", "immediate reconstruction" and "breast conserving surgery". RESULTS:A total of 106 articles were identified for potential inclusion and reviewed in detail. No randomized controlled trials were identified. This study was initially designed to identify and review after a strict selection process, published articles with the highest level of evidence on OPBS. Systematic reviews and metanalyses were not included in this systematic review for methodological reasons. Ten prospective studies fulfilled strict inclusion criteria and were included. Local relapse using OPBS did not exceed 7%. Tumor free margins were retrieved in 86% of cases. Good cosmetic results were obtained in 86% of patients. Most studies showed significant weaknesses, including absence of robust design and methodological limitations, influencing negatively generalizability. CONCLUSIONS:This systematic review proves that current evidence supporting efficacy of OPBS in based on poorly designed and underpowered studies. Further studies and particularly RCTs, are required to assess oncological safety and cosmetic results of OPBS, reporting evidence on long-term oncological results, cosmetic outcomes and survival rates of patients treated with this technique. KEY WORDS:Oncoplastic surgery, Oncological results, Cosmetic results, Cosmesis, Immediate reconstruction, Breast conserving surgery. :Il trattamento chirurgico del carcinoma della mammella ha subito profondi cambiamenti negli ultimi anni. Vari studi hanno dimostrato l’equivalenza in termini di risultati oncologici tra mastectomia e chirurgia conservativa della mammella seguita da radioterapia. La chirurgia conservativa della mammella offre nella maggior parte dei casi risultati favorevoli dal un punto di vista estetico. Ciononostante, in un 10-30% dei casi, i risultati estetici sono deludenti. In questi casi, la chirurgia oncoplastica della mammella che coniuga tecniche di chirurgia oncologica con quelle proprie della chirurgia plastica ha permesso di superare il conflitto tra estensione della resezione tumorale e risultato estetico finale. Varie tecniche di chirurgia oncoplastica sono state proposte e sono sempre più adottate per facilitare la conservazione e preservare l’estetica della mammella. Questa revisione sistematica si propone di valutare i risultati oncologici e cosmetici di chirurgia oncoplastica conservativa conservativa della mammella. Questo lavoro è stata condotto usando dei criteri ben definiti di inclusione ed esclusione, per gli articoli pubblicati fino al 31 luglio 2015. Un totale di 106 articoli sono stati identificati per potenziale inclusione ed esaminati in dettaglio. Dopo una selezione adeguata, 11 articoli hanno formato la base di questo lavoro. Questo studio è stato inizialmente progettato per identificare e poi revisionare dopo un processo di selezione rigoroso, gli articoli pubblicati con il più alto livello di evidenza su chirurgia oncoplastica della mammella. Revisioni sistematiche e metanalisi, non sono stati inclusi per ragioni metodologiche. I risultati di questo lavoro dimostrano che le ricadute locali adoperando la chirurgia oncoplastica non superano il 7%. Margini liberi sono stati recuperati nel 86% dei casi. Buoni risultati cosmetici sono stati ottenuti in 86% dei casi. Ciononostante, si deve riferire che la maggior parte degli studi pubblicati hanno mostrato delle debolezze significative, tra cui l’assenza di un disegno robusto e limiti metodologici, che influenzano negativamente la generalizzabilità dei risultati. Le attuali evidenze a sostegno dell’efficacia di chirurgia oncoplastica si basano su studi mal progettati e etodologicamente indeboliti. Ulteriori studi e in particolare studi randomizzati controllati, sono tenuti a valutare la sicurezza oncologica e i risultati estetici di chirurgia oncoplastica della mammella, riportando elementi sui risultati oncologici a lungo termine, i risultati estetici e tassi di sopravvivenza delle pazienti trattate con questa tecnica.
journal_name
Ann Ital Chirjournal_title
Annali italiani di chirurgiaauthors
Papanikolaou IGsubject
Has Abstractpub_date
2016-01-01 00:00:00pages
199-208eissn
0003-469Xissn
2239-253Xpii
S0003469X16024635journal_volume
87pub_type
杂志文章,评审abstract:AIM:Adrenal gland metastasis are the second most common type of adrenal mass lesions after adenomas and they could be related to numerous malignancies; Literature shows that adrenal metastasis deriving from colorectal cancer are very rare. MATERIAL OF THE STUDY:A 71-year old - male patient, treated two years before wi...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-06-24 00:00:00
abstract::An epidemiologic analysis is carried out on incidence rate, mortality rate and etiology of acute pancreatitis, both from a general point of view and by the Spanish experience. In particular the linkages between biliary lithiasis, alcoholism and acute pancreatitis are investigated. ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::High gastrointestinal hemorrhage represents the more frequent (12-71.1%) and heavy complication of hepatic cirrhosis and correlates to portal hypertension; it is weighed by global mortality which sways from 30 to 50%. High gastrointestinal hemorrhage gives, therefore, a serious of diagnostic and therapeutic problems n...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2000-03-01 00:00:00
abstract:AIM OF THE STUDY:Perioperative and 10 years follow-up risk factors for 1111 consecutive open AAA repairs were statistically analyzed (X2-test and Log-rank test methods for univariate analysis, and logistic regression model and Cox proportional-hazard model for multivariate analysis). Overall operative mortality rate wa...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2007-07-01 00:00:00
abstract:AIM:Performance of routine preoperative esophagogastroduodenal endoscopy (EGE) in patients undergoing bariatric surgery is still a controversial subject. The purpose of our study was to evaluate the benefits of performing preoperative EGE in a cohort of bariatric patients. MATERIAL AND METHODS:The present retrospectiv...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2017-11-29 00:00:00
abstract::Carcinoid tumors of the ampulla are an uncommon finding. The authors report an asymptomatic case of ampullary carcinoid in which the diagnosis was obtained only with definitive histology after radical surgery. The differential diagnosis of these tumors is quite difficult, mostly because they are often asymptomatic. Su...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::In the period 1992-1997, 211 cases of acute pancreatitis were observed: 81 grave cases; 130 slight cases. The ERCP and endoscopic sphincterotomy were performed in 84 cases. From the critical revision 2 groups of patients emerged, homogeneous for etiology and clinical classification, the first submitted to ERCP within ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:AIM:Recto-Urinary Fistula (RUF) is a rare complication of pelvic surgery. Different approaches are reported in literature but a gold standard treatment has not yet been achieved. Transanal Endoscopic Microsurgery (TEM) is a miniinvasive approach with well known advantages as magnification, 3D view and lighting of the o...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract::Intracranial epidermoid cysts are estimated to constitute 0.2 to 1.8% of brain tumours (4) and they can be divided into four categories describing their anatomic origin and frequent primary location: retro-sellar-cerebellopontine angle, parasellar-sylvian fissure, suprasellar-chiasmatic and basilar-posterior fossa. We...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:In this study we retrospectively reviewed data on 311 consecutive elective cholecystectomies, performed for benign disease (cholelithiasis, cholecystitis) in our institution in the last six years, in order to determine the frequency of unexpected gallbladder pre-neoplastic and neoplastic lesions and analys...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2013-05-01 00:00:00
abstract:AIM:Reporting our experience in the treatment of duodenal neoplasms. MATERIAL OF STUDY:Management and treatment of four patients presenting a duodenal neoplasm. RESULTS:Three out of four patients died after surgery for dehiscence and/or bleeding. One, who underwent palliative bypass, died after four months from unkno...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract::Hereditary spherocytosis (HS) is a common inherited hemolytic anemia caused by a defective erythrocyte cellular membrane. Irrespective of type of surgery performed, several case reports comparing the two type of procedures, have not proven any significant difference between serum bilirubin, serum hemoglobin, red blood...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-07-11 00:00:00
abstract:AIM:Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm, its preoperative diagnosis is difficult and therefore inappropriate therapy or postoperative complications are frequent. Reviewing the literature, the purpose of this article was to identify guidelines to improve diagnosis and treatment of SPT. ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract::Gas within the wall of the stomach (emphysematous gastritis) is a rare condition associated with systemic toxicity and very often mortal end. The etiology includes firstly infections with gas-foaming organisms, other predisposing causes are the ingestion of corrosive substances, alcohol abuse and immunosuppression. Bu...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) is a slowly growing tumor, whose natural history is not completely known. Since the hepatocarcinogenetic process may evolve for years in a stepwise fashion from premalignant to overt HCC, detection of early, better treatable tumors is made possible by surveillance of patients at risk. A ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The appropriate treatment of major bile duct injuries is mandatory in order to avoid serious complications, such as bile peritonitis or secondary biliary liver cirrhosis. In the last fourty years, surgical, endoscopic or radiologic techniques of cure have been proposed, but in our opinions, the preferred opt...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:AIM:To evaluate possible adverse consequences and complications following the procedure of Mason-McLeans Vertical Banded Gastroplasty (VBG), and in those cases the possibility to be related to a surgical mistake. PERSONAL EXPERIENCE:It is based on a casuistic of more than 180 patients, submitted to this restrictive ba...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:The AA studied hemodynamic effects in Venous Compression Syndrome of internal Jugular veins, after noninvasive treatment by RIMA (Ricci's manipulation) cervical manipulations. METHODS:Twenty-six subjects were enrolled with at least one jugular vein with complete (white) compression in frontal neck position, ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract::Colo-rectal endometriosis represents a rare pathological event. Exceptionally, a malignant colo-rectal endometrioid carcinoma arising from endometriosis has been reported. In the present case, we describe a 32 year-old woman with clinical and radiological signs of large bowel sub-occlusive syndrome. Histologically, a ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND AND AIMS:The NMVH of the intestine is a rare lesion, typical located in the small bowel. After the first 2 cases, reported in 1982, other 12 cases have been described, ten localized in the jejunual or ileal tract, only 1 in the cecum. SUBJECTS AND METHODS:A case of NMVH of the duodenum, simulating a Crohns ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract::Abdominoperineal resection for rectal cancer are being performed with decreasing frequency in favour of sphincter-saving resections. It remains to be demonstrated that sphincter preservation has not resulted in compromised local disease control and survival. For this purpose 342 patients with rectal carcinoma have bee...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:Primary hyperparathyroidism (pHPT) is often accompanied by underlying thyroid pathology and 1 to 36% of these thyroid pathologies are malignant. How the identification of these lesions affects patient management is unclear. We present a single-center experience with the prevalence of concomitant thyroid cance...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2017-01-01 00:00:00
abstract::After having examined different methods as to continence colostomy, the authors introduce their own control system for the stoma. The study was carried out on 6 colostomized patients. Preliminary, the intraluminal pressure in closed colostomy was recorded. Pressure waves, largely varying from patient to patient, were ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:INTRODUCTION:Tako-tsubo cardiomyopathy is a rapidly reversible form of acute heart failure triggered by stressful events that occur more frequently in postmenopausal women. A central role is supposed to be played by catecholamines and the association with pheocromocytoma is rare. CASE PRESENTATION:We describe a patien...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:Acute hypercalcemia is a serious condition and represents a physician-surgical emergency: the difficulty in setting a precise diagnosis is due to several possibilities that can cause the condition. It is our purpose to critically evaluate the most actual schemes of treatment and the conditions that could fav...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2004-05-01 00:00:00
abstract::The utility of appendectomy performed with laparoscopic procedure is at the present accepted by many surgeons, especially when there is uncertain diagnosis of appendicitis or when an ectopic position is suspected. The authors describe the case report of a 17 years old woman with a diagnosis of subacute appendicitis, i...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Superior mesenteric artery syndrome is an uncommon clinical condition. A case of duodenal vascular compression and a review of the literature are reported in order to clarify the pathophysiology of the disease. Diagnostic values of hypotonic duodenography and angiography are emphasized. Although, the significance of l...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract:INTRODUCTION:The most common microorganisms isolated from septic arthritis are staphylococcus aureus and streptoccocci. Septic arthritis due to Salmonella spp. is extremely rare. PRESENTATION OF CASE:A 55-year-old man, chronic renal failure, is admitted hip arthtritis with newly arised symptoms. The findings were not ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2020-12-03 00:00:00
abstract::"Forgotten" goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. The authors report their experience of 7 cases of residual mediastinal goiter after total thyroidectomy for substernal goiter. Six patients were female and one male with a median age of 56 ye...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2012-11-01 00:00:00
abstract::Thirty youngs and children were submitted to surgical reconstruction of excavated chest. To prevent risk of infections (by Staphylococcus and mixed gram-negative flora) preoperative 100 mg/Kg body weight of cefotaxime was given. In all patients the operative wounds healed regularly. To evaluate cefotaxime level and th...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00