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自体脂肪移植乳房重建供区并发症与满意度:一项系统评价

Donor site complications and satisfaction in autologous fat grafting for breast reconstruction: A systematic review.

作者信息

Wederfoort Jamilla L M, Hebels Sophie A, Heuts Esther M, van der Hulst René R W J, Piatkowski Andrzej A

机构信息

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

Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands.

出版信息

J Plast Reconstr Aesthet Surg. 2022 Apr;75(4):1316-1327. doi: 10.1016/j.bjps.2022.01.029. Epub 2022 Jan 25.

Abstract

BACKGROUND

Breast cancer is the most common cancer in females worldwide. One option for total breast reconstruction following total breast amputation is autologous fat transfer (AFT). However, this is still an upcoming reconstruction technique, and little is known about the donor site complications and their influence on the patient's overall satisfaction.

OBJECTIVES

This systematic review aims to review the current literature regarding donor site complications and donor site satisfaction following AFT for total breast reconstruction.

SEARCH METHODS

A literature search was performed in PubMed, Web of Science, Embase, Cochrane, TRIP pro, and Prospero. All published original literature reporting on complications or satisfaction at the donor site in patients who underwent liposuction, followed by high-volume lipofilling was considered.

MAIN RESULTS

This systematic review resulted in the inclusion of 21 cohort studies, consisting of 2241 participants. None of the studies reported donor site satisfaction scores of any kind. The most frequently reported donor site complication was ecchymosis (268 cases), followed by pain (122 cases), haematoma (58 cases), irregularities (12 cases), burns (four cases), and infection (three cases). Reports on follow-up and management of donor site complications were generally lacking.

AUTHOR'S CONCLUSIONS: Results regarding the donor site are inconclusive. Pre-specified complications, a standardized manner of reporting, long-term follow-up, and patient-reported outcome measures are lacking in most of the studies. The impact of the donor site on quality of life after autologous fat grafting in breast reconstruction remains a blind spot. PROSPERO registration number: CRD42020222870.

摘要

背景

乳腺癌是全球女性中最常见的癌症。全乳切除术后进行全乳重建的一种选择是自体脂肪移植(AFT)。然而,这仍然是一种新兴的重建技术,对于供区并发症及其对患者总体满意度的影响知之甚少。

目的

本系统评价旨在综述目前关于自体脂肪移植进行全乳重建后供区并发症和供区满意度的文献。

检索方法

在PubMed、科学网、Embase、Cochrane、TRIP pro和Prospero中进行文献检索。纳入所有发表的原始文献,这些文献报道了接受抽脂术并随后进行大容量脂肪填充的患者供区的并发症或满意度。

主要结果

本系统评价纳入了21项队列研究,共2241名参与者。没有一项研究报告了任何类型的供区满意度评分。最常报告的供区并发症是瘀斑(268例),其次是疼痛(122例)、血肿(58例)、不平整(12例)、烧伤(4例)和感染(3例)。关于供区并发症随访和处理的报告普遍缺乏。

作者结论

关于供区的结果尚无定论。大多数研究缺乏预先设定的并发症、标准化的报告方式、长期随访以及患者报告的结局指标。在乳房重建中,自体脂肪移植后供区对生活质量的影响仍然是一个盲点。PROSPERO注册号:CRD42020222870。

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