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乳房手术后行假体乳房重建术联合自体脂肪移植对患者生活质量的影响:一项系统评价。

Quality of life after autologous fat transfer additional to prosthetic breast reconstruction in women after breast surgery: A systematic review.

机构信息

Department of Plastic-, Reconstructive-, and Hand Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.

Department of Plastic-, Reconstructive-, and Hand Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.

出版信息

Eur J Surg Oncol. 2021 Apr;47(4):772-777. doi: 10.1016/j.ejso.2020.10.021. Epub 2020 Nov 4.

Abstract

BACKGROUND

Breast cancer is the most frequent form of cancer among women worldwide. Reconstructive surgery may improve the quality of life (QoL), after mastectomy. Various techniques are used to reconstruct the female breast; however, few is known about its specific post-surgery influence represented in patient-reported outcomes.

OBJECTIVE

This systematic review assesses the difference in patient-reported QoL between prosthetic reconstruction alone, and prosthetic reconstruction with additional autologous fat transfer (AFT).

DATA SOURCES

A literature search was performed in PubMed, Embase, Cochrane and CINAHL online databases from inception to February 11th, 2020.

STUDY SELECTION

Inclusion and exclusion criteria were used to assess the eligibility of the retrieved articles. The only eligible studies were cohort studies.

DATA COLLECTION AND ANALYSIS

Relevant data for the research question was extracted from the articles and systematically documented. Results not contributing to answering the objective were intentionally left out. No meta-analysis was realized.

RESULTS

This systematic review resulted in the inclusion of only six relevant studies, all cohort studies, consisting of 1437 unique patients. These studies evaluated the quality of life of patients by means of the validated BREAST-Q questionnaire. Outcomes varied for which reason no definite answer could be provided to whether additional AFT results in a higher QoL.

CONCLUSIONS

It is unclear whether additional AFT after prosthetic surgery leads to a higher QoL when compared to sole prosthetic reconstruction or not. Additional studies, assessing the QoL of patients who received additional AFT, are required to draw solid conclusions.

LEVEL OF EVIDENCE

Level III; systematic literature review of cohort studies.

摘要

背景

乳腺癌是全球女性最常见的癌症类型。乳房再造术可以改善乳房切除术后的生活质量(QoL)。目前有多种技术用于重建女性乳房,但对于患者报告的结果中具体的术后影响知之甚少。

目的

本系统评价评估了单纯假体重建与假体重建联合自体脂肪移植(AFT)在患者报告的 QoL 方面的差异。

数据来源

从建库至 2020 年 2 月 11 日,在 PubMed、Embase、Cochrane 和 CINAHL 在线数据库中进行了文献检索。

研究选择

使用纳入和排除标准评估检索文章的合格性。唯一合格的研究是队列研究。

数据收集和分析

从文章中提取与研究问题相关的数据,并进行系统记录。没有对有助于回答目标的结果进行分析。未进行荟萃分析。

结果

本系统评价仅纳入了 6 项符合条件的研究,均为队列研究,共纳入 1437 例患者。这些研究使用经过验证的 BREAST-Q 问卷评估了患者的生活质量。由于结果不同,因此无法确定假体手术后联合 AFT 是否会导致更高的 QoL。

结论

目前尚不清楚与单纯假体重建相比,假体手术后联合 AFT 是否会导致更高的 QoL。需要进行更多评估接受额外 AFT 的患者的 QoL 的研究,以得出确凿的结论。

证据水平

三级;队列研究的系统文献评价。

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