Liu Jiameng, Zheng Xiaobin, Lin Shunguo, Han Hui, Xu Chunsen
The Graduate School of Fujian Medical University, Fuzhou, 350000, Fujian Province, China.
Department of Breast Surgery, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fuzhou, 350001, Fujian Province, China.
Support Care Cancer. 2022 Jul;30(7):5659-5668. doi: 10.1007/s00520-022-06919-5. Epub 2022 Feb 18.
The use of acellular dermal matrices (ADMs) and mesh reopened the possibility for the prepectoral single-stage breast reconstruction (PBR). The complications of single-stage breast reconstruction after PRB are controversial. We conducted a systematic review and meta-analysis of the impact of implant plane on single-stage breast reconstruction. Our aim was to evaluate the different postoperative complications between patients receiving prepectoral breast reconstruction and subpectoral breast reconstruction (SBR) on single-stage breast reconstruction.
A comprehensive research on databases including PubMed, Embase, and Cochrane libraries was performed to retrieve literature evaluating the effect of implant plane on single-stage breast reconstruction from 2010 to 2020. All included studies were evaluated the complications after single-stage breast reconstruction. Only studies comparing patients who underwent prepectoral reconstruction with a control group who underwent subpectoral reconstruction were included.
A total of 13 studies were included in the meta-analysis, with a total of 1724 patients. In general, compared with SBR group, the PBR significantly reduced the risk of total complications (including seroma, hematoma, necrosis, wound dehiscence, infection, capsular contraction, implant loss/remove, and rippling) after single-stage breast reconstruction (OR: 0.54, 95% CI: 0.44-0.67, p < 0.001). Compared with the SBR group, the PBR had remarkably decreased capsular contracture (OR: 0.40, 95% CI: 0.27-0.58, p < 0.001) and postoperative infection (OR: 0.58, 95% CI: 0.36-0.95, p = 0.03).
The PBR is a safe single-stage breast reconstruction with fewer postoperative complications. It is an alternative surgical method for SBR.
脱细胞真皮基质（ADM）和网片的使用为胸肌前单阶段乳房重建（PBR）重新开启了可能性。PRB后单阶段乳房重建的并发症存在争议。我们对植入平面在单阶段乳房重建中的影响进行了系统评价和荟萃分析。我们的目的是评估接受胸肌前乳房重建和胸肌下乳房重建（SBR）的患者在单阶段乳房重建术后的不同并发症。
对包括PubMed、Embase和Cochrane图书馆在内的数据库进行全面检索，以获取2010年至2020年评估植入平面在单阶段乳房重建中作用的文献。所有纳入研究均评估了单阶段乳房重建后的并发症。仅纳入比较接受胸肌前重建的患者与接受胸肌下重建的对照组的研究。
荟萃分析共纳入13项研究，总计1724例患者。总体而言，与SBR组相比，PBR显著降低了单阶段乳房重建后总并发症（包括血清肿、血肿、坏死、伤口裂开、感染、包膜挛缩、植入物丢失/取出和波纹）的风险（OR：0.54，95%CI：0.44-0.67，p<0.001）。与SBR组相比，PBR的包膜挛缩（OR：0.40，95%CI：0.27-0.58，p<0.001）和术后感染（OR：0.58，95%CI：0.36-0.95，p=0.03）明显减少。
PBR是一种安全的单阶段乳房重建方法，术后并发症较少。它是SBR的一种替代手术方法。
