Zhou Yiwen, Wang Jing, Li Haizhou, Liang Xiao, Bae Jinhong, Huang Xiaolu, Li Qingfeng
Shanghai, People's Republic of China From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Plast Reconstr Surg. 2016 Jan;137(1):44e-57e. doi: 10.1097/PRS.0000000000001981.
The main drawback of autologous fat grafting, which is commonly used for soft-tissue augmentation, is the high resorption rate. Cell-assisted lipotransfer has been used to improve fat graft survival; however, evidence for its efficacy and safety is still lacking.
The authors searched PubMed, Cochrane Library, EBSCO, and EMBASE for clinical studies on cell-assisted lipotransfer published from 2008 through 2014. A meta-analysis was conducted to pool the estimated fat survival rate. Incidence of complications and incidence of multiple operations were calculated.
Seventeen articles involving 387 cases were included in the systematic review. The pooled fat survival rate was significantly higher in the cell-assisted lipotransfer group than in the nonlipotransfer group (60 percent versus 45 percent, p = 0.0096). Complication incidence was similar in the two groups. Cell-assisted lipotransfer significantly improved fat survival in the face (by 19 percent) and reduced the incidence of multiple operations (by 13.6 percent). In breast fat grafting, however, fat survival was improved by only 9 percent, which was not statistically significant. Meanwhile, lipotransfer in breast cases was associated with a higher complication incidence compared with face cases (p < 0.001).
This study demonstrates that cell-assisted lipotransfer has better efficacy than conventional fat grafting (non-cell-assisted lipotransfer). It is more applicable to face cases than to breast cases. Until now, there has not been enough evidence of the superiority of cell-assisted lipotransfer over conventional fat grafting for reducing complications.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
自体脂肪移植常用于软组织填充，其主要缺点是吸收率高。细胞辅助脂肪移植已被用于提高脂肪移植的存活率；然而，其有效性和安全性的证据仍然不足。
作者检索了PubMed、Cochrane图书馆、EBSCO和EMBASE，以查找2008年至2014年发表的关于细胞辅助脂肪移植的临床研究。进行荟萃分析以汇总估计的脂肪存活率。计算并发症发生率和多次手术发生率。
系统评价纳入了17篇文章，涉及387例病例。细胞辅助脂肪移植组的汇总脂肪存活率显著高于非脂肪移植组（60%对45%，p = 0.0096）。两组的并发症发生率相似。细胞辅助脂肪移植显著提高了面部脂肪存活率（提高了19%），并降低了多次手术的发生率（降低了13.6%）。然而，在乳房脂肪移植中，脂肪存活率仅提高了9%，无统计学意义。同时，与面部病例相比，乳房病例的脂肪移植并发症发生率更高（p < 0.001）。
本研究表明，细胞辅助脂肪移植比传统脂肪移植（非细胞辅助脂肪移植）具有更好的疗效。它更适用于面部病例而非乳房病例。到目前为止，尚无足够证据表明细胞辅助脂肪移植在减少并发症方面优于传统脂肪移植。
临床问题/证据水平：治疗性，III级。
