Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study

Abstract Background Robotic surgery is increasingly being adopted for breast cancer treatment. However, robust clinical evidence regarding its effectiveness and safety remains limited. This retrospective cohort study aimed to compare the surgical quality and short-term outcomes of robotic-assisted a...

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Main Authors: Zhijie Wu, Qiwen Liu, Zongyan Li, Zuxiao Chen, Yongxin Wu, Yunxiang Luo, Lina Wei, Qiongyu Hu, Haiyan Li
Format: Article
Language:English
Published: BMC 2025-05-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-025-03794-2
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author Zhijie Wu
Qiwen Liu
Zongyan Li
Zuxiao Chen
Yongxin Wu
Yunxiang Luo
Lina Wei
Qiongyu Hu
Haiyan Li
author_facet Zhijie Wu
Qiwen Liu
Zongyan Li
Zuxiao Chen
Yongxin Wu
Yunxiang Luo
Lina Wei
Qiongyu Hu
Haiyan Li
author_sort Zhijie Wu
collection DOAJ
description Abstract Background Robotic surgery is increasingly being adopted for breast cancer treatment. However, robust clinical evidence regarding its effectiveness and safety remains limited. This retrospective cohort study aimed to compare the surgical quality and short-term outcomes of robotic-assisted axillary lymph node dissection (R-ALND) and endoscopic-assisted axillary lymph node dissection (E-ALND) in patients with node-positive breast cancer. Here, we report the short-term outcomes of this trial. Methods This single-center retrospective study compared the short-term efficacy and safety of R-ALND and E-ALND in patients with node-positive breast cancer. Patients who underwent surgery at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2022 and October 2024 were included. Clinical and pathological characteristics, surgical outcomes, and postoperative complications were analyzed. Results A total of 56 patients were included, with 29 undergoing E-ALND and 27 undergoing R-ALND. The R-ALND group demonstrated significantly shorter operative times (43.37 ± 12.40 min vs. 60.10 ± 19.37 min, p < 0.001) and lower mean intraoperative blood loss (3.26 ± 2.40 ml vs. 9.24 ± 4.29 ml, p < 0.001). Postoperatively, the R-ALND group exhibited better upper limb function and sensation, as evidenced by significantly lower DASH scores at 1-month (10.87 ± 1.35 vs. 14.64 ± 3.49, p < 0.001) and 3-month (6.68 ± 1.86 vs. 9.24 ± 2.74, p < 0.001) follow-ups. Additionally, the R-ALND group had fewer postoperative complications, including a reduced incidence of sensory disturbances, burning sensations, and numbness in the upper limb. Conclusion Compared with E-ALND, R-ALND significantly reduces intraoperative blood loss and postoperative complications, with less impact on upper limb function and sensory outcomes. These findings indicate that R-ALND may provide better clinical benefits for patients requiring axillary lymph node dissection in the management of breast cancer.
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spelling doaj-art-db763f34eebb4b91a06bdca0a39191f02025-08-20T03:09:19ZengBMCWorld Journal of Surgical Oncology1477-78192025-05-012311810.1186/s12957-025-03794-2Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative studyZhijie Wu0Qiwen Liu1Zongyan Li2Zuxiao Chen3Yongxin Wu4Yunxiang Luo5Lina Wei6Qiongyu Hu7Haiyan Li8Department of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen UniversityAbstract Background Robotic surgery is increasingly being adopted for breast cancer treatment. However, robust clinical evidence regarding its effectiveness and safety remains limited. This retrospective cohort study aimed to compare the surgical quality and short-term outcomes of robotic-assisted axillary lymph node dissection (R-ALND) and endoscopic-assisted axillary lymph node dissection (E-ALND) in patients with node-positive breast cancer. Here, we report the short-term outcomes of this trial. Methods This single-center retrospective study compared the short-term efficacy and safety of R-ALND and E-ALND in patients with node-positive breast cancer. Patients who underwent surgery at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2022 and October 2024 were included. Clinical and pathological characteristics, surgical outcomes, and postoperative complications were analyzed. Results A total of 56 patients were included, with 29 undergoing E-ALND and 27 undergoing R-ALND. The R-ALND group demonstrated significantly shorter operative times (43.37 ± 12.40 min vs. 60.10 ± 19.37 min, p < 0.001) and lower mean intraoperative blood loss (3.26 ± 2.40 ml vs. 9.24 ± 4.29 ml, p < 0.001). Postoperatively, the R-ALND group exhibited better upper limb function and sensation, as evidenced by significantly lower DASH scores at 1-month (10.87 ± 1.35 vs. 14.64 ± 3.49, p < 0.001) and 3-month (6.68 ± 1.86 vs. 9.24 ± 2.74, p < 0.001) follow-ups. Additionally, the R-ALND group had fewer postoperative complications, including a reduced incidence of sensory disturbances, burning sensations, and numbness in the upper limb. Conclusion Compared with E-ALND, R-ALND significantly reduces intraoperative blood loss and postoperative complications, with less impact on upper limb function and sensory outcomes. These findings indicate that R-ALND may provide better clinical benefits for patients requiring axillary lymph node dissection in the management of breast cancer.https://doi.org/10.1186/s12957-025-03794-2Robotic-assisted axillary lymph node dissection (R-ALND)Endoscopic-assisted axillary lymph node dissection (E-ALND)Node-positive breast cancerPostoperative complicationsUpper limb function
spellingShingle Zhijie Wu
Qiwen Liu
Zongyan Li
Zuxiao Chen
Yongxin Wu
Yunxiang Luo
Lina Wei
Qiongyu Hu
Haiyan Li
Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study
World Journal of Surgical Oncology
Robotic-assisted axillary lymph node dissection (R-ALND)
Endoscopic-assisted axillary lymph node dissection (E-ALND)
Node-positive breast cancer
Postoperative complications
Upper limb function
title Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study
title_full Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study
title_fullStr Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study
title_full_unstemmed Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study
title_short Efficacy and safety of robotic-assisted versus endoscopic-assisted axillary lymph node dissection in node-positive breast cancer: a retrospective comparative study
title_sort efficacy and safety of robotic assisted versus endoscopic assisted axillary lymph node dissection in node positive breast cancer a retrospective comparative study
topic Robotic-assisted axillary lymph node dissection (R-ALND)
Endoscopic-assisted axillary lymph node dissection (E-ALND)
Node-positive breast cancer
Postoperative complications
Upper limb function
url https://doi.org/10.1186/s12957-025-03794-2
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