Michot A, Alet J-M, Pélissier P, Grolleau-Raoux J-L, Bodin F, Chaput B
Service de chirurgie plastique, reconstructrice et chirurgie de la main, CHU de Bordeaux, université Bordeaux Segalen, Bordeaux, France.
Service de chirurgie plastique, reconstructrice et chirurgie de la main, CHU de Bordeaux, université Bordeaux Segalen, Bordeaux, France.
Ann Chir Plast Esthet. 2016 Feb;61(1):e9-e19. doi: 10.1016/j.anplas.2015.07.009. Epub 2015 Aug 28.
Combined aesthetic procedures are an increasing procedure and demands of the patients. The authors have assembled concrete arguments detailing the risks of combined-surgery associating abdominoplasty and mammoplasty relative to abdominoplasty alone. The purpose of this study was to compare abdominoplasty alone versus abdominoplasty combined with breast surgery in terms of short-term complications, in support of surgical choices.
Through application of the PRISMA criteria, we have realized a systematic review of the literature from 1969 to April 2015 in English and French languages by searching in MEDLINE®, PubMed central, Embase and Cochrane Library databases.
The levels of evidence for each article were evaluated. Statistical analysis of the results was carried out through association parameters including statistical tests and Odds ratios were calculated for each complication when data was available.
We included 32 observational studies that met the inclusion criteria but only four with usable data. We highlighted a combined Odds ratio of respectively 5.35 and 14.71 for major complications in these studies for combined-surgery compared with abdominoplasty alone.
The results of this systematic review appears in favor of an increase in major complications related to abdominoplasty combined with breast surgery compared to abdominoplasty alone but the level of evidence of included studies is low or moderate. Prospective cohort comparative studies are necessary to provide strong evidence. However, we recommend to avoid this procedure in massive weight loss patients or patients with thromboembolism history.
联合美容手术的开展越来越多，患者对此的需求也日益增加。作者已收集了具体论据，详细阐述了腹壁成形术与乳房成形术联合手术相较于单纯腹壁成形术的风险。本研究的目的是比较单纯腹壁成形术与腹壁成形术联合乳房手术在短期并发症方面的差异，以辅助手术选择。
通过应用PRISMA标准，我们在MEDLINE®、PubMed中心、Embase和Cochrane图书馆数据库中进行检索，对1969年至2015年4月期间以英文和法文发表的文献进行了系统综述。
评估每篇文章的证据水平。当有可用数据时，通过包括统计检验在内的关联参数对结果进行统计分析，并计算每种并发症的比值比。
我们纳入了32项符合纳入标准的观察性研究，但只有4项研究的数据可用。我们强调，在这些研究中，联合手术的主要并发症的合并比值比与单纯腹壁成形术相比分别为5.35和14.71。
本系统综述的结果表明，与单纯腹壁成形术相比，腹壁成形术联合乳房手术相关的主要并发症有所增加，但纳入研究的证据水平为低或中等。需要进行前瞻性队列比较研究以提供有力证据。然而，我们建议在大量减重患者或有血栓栓塞病史的患者中避免这种手术。
