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《Aeroform 组织扩张器对基于假体的乳房重建结局的影响:系统评价和荟萃分析》

The Impact of Aeroform Tissue Expanders on the Outcomes of Implant-Based Breast Reconstruction; A Systematic Review and Meta-Analysis.

机构信息

Department of Plastic and Reconstructive Surgery, Faculty of Medicine (Boys), Al-Azhar University, Nasr City, Al Mokhaym Al Daem, Gameat Al Azhar, Cairo, Egypt.

Department of Plastic and Reconstructive Surgery, El-Sahel Teaching Hospital, Cairo, Egypt.

出版信息

Aesthetic Plast Surg. 2023 Feb;47(1):130-143. doi: 10.1007/s00266-022-02901-y. Epub 2022 May 13.

Abstract

BACKGROUND

Breast reconstruction can improve the quality of patients' lives by restoring the breasts' natural appearance. Saline-based tissue expanders are associated with significant drawbacks. The current systematic review and meta-analysis aimed to reveal the usability, safety, and economic burden of AeroForm-based tissue expanders for breast reconstruction.

METHODS

An extensive systematic literature review was implemented from inception to 9 December 2021. All clinical studies that included women with breast cancer subjected to AeroForm-based tissue expansion for breast reconstruction were included in the study.

RESULTS

This systematic review included eleven articles consisting of 748 patients. There were 1220 reconstructed breasts in which 530 (43.44%) breasts were reconstructed using AeroForm devices. AeroForm-based tissue expanders were associated with shorter duration to complete breast expansion (MD-35.22; 95% -46.65, -23.78;P<0.001) and complete reconstruction (MD-30.511; 95% -54.659, -6.636;P=0.013). The overall satisfaction rate of the aesthetic results of the AeroForm expanders was 81.4% (95%CI; 60.3% to 92.6%,P=0.006) and 64.6% (95%CI; 53.8% to 74%,P=0.008) for patients and surgeons. Patients subjected to saline-based breast reconstruction were 1.17 times at high risk to develop breast-related adverse events (RR1.17; 95% 0.86, 1.58; P=0.31). This includes a high risk of mastectomy flap necrosis (RR1.91; 95% 1.03, 3.55;P=0.04) and post-operative wound infection (RR 1.63; 95% 0.91, 2.91;P=0.1).

CONCLUSION

AeroForm-based tissue expanders represent a new era of breast reconstruction. These devices provided an earlier transition to exchange for the permanent implant with a convenient and comfortable expansion process. This was associated with a high satisfaction rate for patients and surgeons.

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

乳房重建可以通过恢复乳房的自然外观来提高患者的生活质量。基于盐水的组织扩张器存在显著的缺点。本系统评价和荟萃分析旨在揭示基于 AeroForm 的组织扩张器在乳房重建中的可用性、安全性和经济负担。

方法

从成立到 2021 年 12 月 9 日,进行了广泛的系统文献检索。所有纳入接受基于 AeroForm 的组织扩张进行乳房重建的乳腺癌女性的临床研究均纳入本研究。

结果

本系统评价包括 11 篇文章,共 748 例患者。其中 1220 个乳房进行了重建,其中 530 个(43.44%)乳房采用 AeroForm 装置进行了重建。与基于盐水的组织扩张器相比,AeroForm 基于组织扩张器的乳房扩张完成时间更短(MD-35.22;95%CI-46.65,-23.78;P<0.001)和完全重建(MD-30.511;95%CI-54.659,-6.636;P=0.013)。AeroForm 扩张器的美学效果整体满意度率为 81.4%(95%CI;60.3%至 92.6%,P=0.006)和 64.6%(95%CI;53.8%至 74%,P=0.008)为患者和外科医生。接受基于盐水的乳房重建的患者发生乳房相关不良事件的风险高 1.17 倍(RR1.17;95%CI0.86,1.58;P=0.31)。这包括乳房切除术皮瓣坏死的高风险(RR1.91;95%CI1.03,3.55;P=0.04)和术后伤口感染(RR 1.63;95%CI0.91,2.91;P=0.1)。

结论

基于 AeroForm 的组织扩张器代表了乳房重建的新时代。这些设备为早期过渡到永久性植入物提供了便利和舒适的扩展过程,同时患者和外科医生的满意度很高。

证据水平 III:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2a/9944028/1ff30676d1b3/266_2022_2901_Fig1_HTML.jpg

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