Momoh Adeyiza O, Ahmed Raouf, Kelley Brian P, Aliu Oluseyi, Kidwell Kelley M, Kozlow Jeffrey H, Chung Kevin C
Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, MI, USA,
Ann Surg Oncol. 2014 Jan;21(1):118-24. doi: 10.1245/s10434-013-3284-z. Epub 2013 Oct 1.
To conduct a systematic review of the literature to assess outcomes data on complications associated with implant-based breast reconstruction performed before or after chest wall radiation to assist in guiding the decision-making process for reconstruction of the irradiated breast.
Studies from a PubMed search that met predetermined inclusion criteria were identified and included. Complications of interest were low- and high-grade capsular contractures, minor and major complications, reconstruction failure rates, and reconstruction completion rates. Pooled complication rates were calculated.
A total of 26 articles were included in the study after screening 1,006 publications, with 14 studies presenting data on prereconstruction radiation and 23 studies presenting data on postreconstruction radiation. Complication rates evaluated in patients exposed to radiation before or after implant reconstruction were not significantly different. Reconstruction failure rates were similar at 19 and 20 % for pre- and postreconstruction radiation patients, respectively. Completion rates were similar at 83 and 80 % for pre- and postreconstruction radiation patients, respectively.
Review of the current literature suggests similar overall success and failure rates with radiotherapy provided both before and after reconstruction. Failure rates in both groups of patients are clinically significant when considering implant reconstruction in the setting of radiation.
对文献进行系统回顾，以评估胸壁放疗前后进行的植入物乳房重建相关并发症的结局数据，从而辅助指导放疗后乳房重建的决策过程。
通过PubMed检索，确定并纳入符合预定纳入标准的研究。关注的并发症包括轻度和重度包膜挛缩、轻微和严重并发症、重建失败率以及重建完成率。计算合并并发症发生率。
在筛选了1006篇出版物后，该研究共纳入26篇文章，其中14项研究提供了重建前放疗的数据，23项研究提供了重建后放疗的数据。植入物重建前后接受放疗的患者的并发症发生率无显著差异。重建前和重建后放疗患者的重建失败率分别为19%和20%，相似。重建前和重建后放疗患者的完成率分别为83%和80%，相似。
对当前文献的回顾表明，重建前后进行放疗的总体成功率和失败率相似。在考虑放疗情况下进行植入物重建时，两组患者的失败率在临床上都具有重要意义。
