From the Department of Plastic and Reconstructive Surgery, Peking University People's Hospital.
Plast Reconstr Surg. 2021 Jan 1;147(1):1-10. doi: 10.1097/PRS.0000000000007416.
The purpose of this study was to evaluate the safety and effectiveness of autologous fat grafting after radiotherapy.
All studies published before December of 2019 were collected by searching on PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, and Wanfang Data. After independently screening the studies and extracting the data, Stata was applied to perform meta-analysis.
Seventeen qualified articles were eventually included, involving a total of 1658 patients, of which 1555 underwent autologous fat grafting. Overall, empirically from the data, the use of autologous fat grafting after radiotherapy does not increase the incidence of complications or the risk of tumor recurrence. Through statistical analysis, the authors found that 152 patients suffered complications after undergoing autologous fat grafting [152 of 1555 (9.8 percent)]; 72 patients suffered complications after undergoing postradiotherapy autologous fat grafting [72 of 1040 (6.9 percent)], including seven cases of tumor recurrence [seven of 1040 (0.7 percent)]; and 80 patients suffered complications after undergoing autologous fat grafting without radiotherapy [80 of 515 (15.5 percent)], including seven cases of tumor recurrence [seven of 515 (1.4 percent)]. The authors also found that 970 of 1040 patients (93.3 percent) were satisfied with the results of postradiotherapy autologous fat grafting for breast reconstruction.
This study has provided an evidence-based conclusion supporting the use of autologous fat grafting for breast reconstruction after radiotherapy. Autologous fat grafting can effectively correct breast deformity and contracture caused by breast-conserving therapy and radiotherapy and increase patient satisfaction without increasing the rate of tumor recurrence.
本研究旨在评估放疗后自体脂肪移植的安全性和有效性。
通过在 PubMed、Embase、Cochrane、Web of Science、中国知网和万方数据上检索，收集了截至 2019 年 12 月前发表的所有研究。经过独立筛选研究和提取数据后，应用 Stata 进行荟萃分析。
最终纳入了 17 篇合格的文章，共涉及 1658 例患者，其中 1555 例行自体脂肪移植。总体而言，从数据上看，放疗后使用自体脂肪移植并不会增加并发症的发生率或肿瘤复发的风险。通过统计学分析，作者发现 152 例患者在接受自体脂肪移植后出现并发症[152 例（1555 例中的 9.8%）]；72 例患者在接受放疗后自体脂肪移植后出现并发症[72 例（1040 例中的 6.9%）]，包括 7 例肿瘤复发[7 例（1040 例中的 0.7%）]；80 例患者在未接受放疗的情况下接受自体脂肪移植后出现并发症[80 例（515 例中的 15.5%）]，包括 7 例肿瘤复发[7 例（515 例中的 1.4%）]。作者还发现，1040 例患者中有 970 例（93.3%）对放疗后自体脂肪移植用于乳房重建的结果表示满意。
本研究提供了支持放疗后行自体脂肪移植用于乳房重建的循证结论。自体脂肪移植可以有效纠正保乳治疗和放疗引起的乳房畸形和挛缩，提高患者满意度，而不会增加肿瘤复发率。
