M. Macco (Rotterdam, Netherlands)
Franciscus Gasthuis en VlietlandAuthor Of 1 Presentation
86P - The impact of the introduction of vacuum assisted excision on clinical management and outcomes of benign and high-risk lesions
Abstract
Background
The use of VAE for high-risk lesions remains controversial and guidelines are ambiguous. In this study we evaluate and demonstrate how the introduction of VAE impacts the management and clinical outcomes of benign and high-risk lesions in our hospital.
Methods
A retrospective database cohort study was conducted to compare the available operation room time, and excision, re-excision, recurrence, complications and upgrading rates before and after the introduction of VAE. All patients treated for a benign or high-risk lesion in the period from January 2016 up to 2019 were included in the study. To demonstrate the difference in treatment the results for VAE and surgical excision (SE) in the after group were presented separately.
Results
A total of 319 lesions were excised in our hospital during the study period, of which 118 were excised through VAE. The proportion of excised lesions was comparable in the before and after group, but the proportion of SE decreased since the introduction of VAE. High-risk lesions were significantly more often treated with SE than VAE due to the high rate of surgically excised papillary lesions. Recurrence, re-excision and complication rates were comparable in the before and after group. Nearly all malignancies found after excision through VAE or SE were good differentiated in situ carcinoma, and no malignancies were detected during the follow-up of benign and high-risk lesions.
Conclusions
The introduction of VAE reduced OR time for benign and high-risk lesions, implicating that more OR time was available for malignant lesions. Re-excision, recurrence and upgrade rates remained low and could possibly be further reduced by better informing the patient prior to the procedure. This study contributes to the accumulating evidence for the wider deployment of VAE as a treatment option for all high-risk lesions.
Legal entity responsible for the study
Franciscus Gasthuis en Vlietland.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.