乳晕周围切口与其他两种（乳房下皱襞和腋窝）切口行隆胸术后的包膜挛缩率：一项荟萃分析

Capsular Contracture Rate After Breast Augmentation with Periareolar Versus Other Two (Inframammary and Transaxillary) Incisions: A Meta-Analysis.

作者信息

Li Shangshan, Chen Lin, Liu Wenyue, Mu Dali, Luan Jie

机构信息

Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China.

出版信息

Aesthetic Plast Surg. 2018 Feb;42(1):32-37. doi: 10.1007/s00266-017-0965-1. Epub 2017 Sep 15.

DOI:10.1007/s00266-017-0965-1

PMID:28916908

Abstract

BACKGROUND

Capsular contracture has been the most common complication of cosmetic breast augmentation. The effect of incision pattern on capsular contracture is still unclear. This meta-analysis demonstrates current evidence with regard to the comparison of capsular contracture rate between periareolar and other two (transaxillary and inframammary) incisions.

METHODS

PubMed, EMBASE, and Cochrane databases were searched up to January 2017. The results of selected studies were meta-analyzed to obtain a pooled odds ratio of the effect of periareolar versus other two incision patterns (transaxillary or inframammary incision) of breast augmentation on capsular contracture rates. In addition, subgroup analyses were performed on periareolar versus transaxillary groups and periareolar versus inframammary groups with regard to capsular contracture rate.

RESULTS

Seven comparative studies were selected and meta-analyzed. Five of the seven studies reported a higher rate of capsular contracture on patients with periareolar incisions. The results showed a significantly higher rate of capsular contracture with periareolar incisions compared with other two incisions (OR, 1.83; 95% CI, 1.06-3.15, p = 0.03). Subgroup results showed no significant difference of capsular contracture between periareolar incisions and transaxillary incisions (OR, 0.94; 95% CI, 0.52-1.64, p = 0.79) and showed a significantly higher rate of capsular contracture in periareolar incisions compared to inframammary incisions (OR, 1.91; 95% CI, 1.06-3.43, p = 0.03).

CONCLUSION

The results of this meta-analysis demonstrate the contributing effects of periareolar breast augmentation on the rate of capsular contracture. However, more studies with longer tracking periods and higher quality should be conducted to further verify this conclusion.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

包膜挛缩一直是隆乳术最常见的并发症。切口方式对包膜挛缩的影响仍不明确。本荟萃分析展示了乳晕周围切口与其他两种（腋下和乳房下皱襞）切口在包膜挛缩率比较方面的现有证据。

方法

检索截至2017年1月的PubMed、EMBASE和Cochrane数据库。对所选研究结果进行荟萃分析，以获得乳晕周围切口与其他两种隆乳切口方式（腋下或乳房下皱襞切口）对包膜挛缩率影响的合并比值比。此外，就包膜挛缩率对乳晕周围组与腋下组以及乳晕周围组与乳房下皱襞组进行亚组分析。

结果

选取七项比较研究并进行荟萃分析。七项研究中的五项报告乳晕周围切口患者的包膜挛缩率更高。结果显示，与其他两种切口相比，乳晕周围切口的包膜挛缩率显著更高（比值比，1.83；95%置信区间，1.06 - 3.15，p = 0.03）。亚组结果显示，乳晕周围切口与腋下切口之间的包膜挛缩无显著差异（比值比，0.94；95%置信区间，0.52 - 1.64，p = 0.79），且与乳房下皱襞切口相比，乳晕周围切口的包膜挛缩率显著更高（比值比，1.91；95%置信区间，1.06 - 3.43，p = 0.03）。