探讨早期乳腺癌腔镜辅助保留乳头乳晕的乳房切除术（NSM）及Ⅰ期乳房重建的临床应用效果。

回顾性分析2020年6月至2024年6月在重庆医科大学附属妇女儿童医院行NSM及Ⅰ期乳房重建术的38例早期乳腺癌患者临床资料，根据手术方式分为腔镜组（25例）和开放组（13例）。2组患者手术时间、术中出血量比较采用独立样本t检验，住院时间、乳房外观满意度评分（术前和术后）比较采用非参数Mann-Whitney 检验，患者术前和术后满意度的组内比较采用配对秩和检验。

腔镜组手术时间长于开放组，差异有统计学意义［（165.84±16.30） min 比（99.69±12.35） min，t=12.813，P<0.001］；2组患者术中出血量及术后住院时间比较，差异均无统计学意义（t=1.456，P=0.154；Z=-0.135，P=0.199）。2组患者术前乳房外观满意度比较差异无统计学意义［48.00（39.00，55.50） 比53.00（44.00，58.00），Z=-0.856，P＝0.392）］，腔镜组术后乳房外观满意度高于开放组［42.00（40.00，45.50）比38.00（33.00，43.00），Z=-2.501，P=0.012］。2组患者手术后乳房外观满意度均优于手术前，差异均具有统计学意义（Z=-2.432、-2.906，P=0.015、0.004）。

腔镜辅助下早期乳腺癌NSM及Ⅰ期乳房重建美观、安全、可操作性高，术后患者满意度高，可以推广应用。

To investigate the clinical application and outcomes of endoscopic nipple-sparing mastectomy （NSM） and immediate reconstruction in early breast cancer.

The clinical data of 38 patients with early breast cancer who underwent surgery in the Women and Children's Hospital of Chongqing Medical University from June 2020 to June 2024 were retrospectively analyzed. According to the type of surgery，patients were divided into the endoscopic surgery group （n=25） and the open surgery group （n=13）. Operation time，intraoperative blood loss were compared between two groups using independent sample t test； hospital stay，preoperative and postoperative patient satisfaction with breast appearance were compared between two groups using the nonparametric Mann–Whitney test，and pre- and postoperative patient satisfaction within-group was compared by paired rank-sum test.

Operation time was significantly longer in the endoscopic surgery group than in the open surgery group ［（165.84±16.30） min vs （99.69±12.35） min，t=12.813，P<0.001］. Intraoperative blood loss and postoperative hospital stay showed no statistically significant difference（t=1.456，P=0.154；Z=-0.135，P=0.199）. The patient satisfaction with breast appearance showed no significant differences between two groups before operation［48.00（39.00，55.50） vs 53.00（44.00，58.00），Z=-0.856，P＝0.392）］，while postoperative satisfaction was significantly higher in the endoscopic surgery group ［42.00（40.00，45.50） vs 38.00（33.00，43.00），Z=-2.501，P=0.012］. The patient satisfaction with breast appearance after surgery was significantly better than that before surgery （Z=-2.432，-2.906，P=0.015，0.004）.

The endoscope-assisted NSM and immediate reconstruction in early breast cancer has the advantages of good aesthetic effect，safety and operability，and high postoperative patient satisfaction worthy of clinical application.