Department of Breast Surgery, Huangpu Branch, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Int Wound J. 2023 May;20(5):1361-1368. doi: 10.1111/iwj.13982. Epub 2022 Nov 6.
We performed a meta-analysis to evaluate the oncological results in women with wound complications following mastectomy and immediate breast reconstruction. A systematic literature search up to August 2022 was performed and 1618 subjects with mastectomy and immediate breast reconstruction at the baseline of the studies; 443 of them were with wound complications, and 1175 were with no wound complications as a control. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the oncological results in women with wound complications following mastectomy and immediate breast reconstruction using dichotomous or contentious methods with a random or fixed-effect model. The wound complications had a significantly longer length of time to adjuvant therapy (MD, 9.44; 95% CI, 4.07-14.82, P < .001) compared with no wound complications in subjects with mastectomy and immediate breast reconstruction. However, no significant difference was found between wound complications and no wound complications in subjects with mastectomy and immediate breast reconstruction in breast cancer recurrence (OR, 1.96; 95% CI, 0.95-4.06, P = .07), death rates (OR, 1.95; 95% CI, 0.89-4.27, P = .09), and kind of immediate breast reconstruction (OR, 1.01; 95% CI, 0.53-1.92, P = .98). The wound complications had a significantly longer length of time to adjuvant, however, no significant difference was found in breast cancer recurrence, death rates, and kind of immediate breast reconstruction. The analysis of outcomes should be done with caution even though no low sample size was found in the meta-analysis but a low number of studies was found in certain comparisons.
我们进行了一项荟萃分析，以评估乳房切除术和即刻乳房重建后出现伤口并发症的女性的肿瘤学结果。系统的文献检索截至 2022 年 8 月，共有 1618 名接受乳房切除术和即刻乳房重建的患者作为研究的基线，其中 443 名患有伤口并发症，1175 名作为对照无伤口并发症。使用二项分类或连续方法，采用随机或固定效应模型，计算优势比（OR）和均数差（MD）及其 95%置信区间（CI），以评估乳房切除术和即刻乳房重建后出现伤口并发症的女性的肿瘤学结果。与即刻乳房重建后无伤口并发症的患者相比，即刻乳房重建后有伤口并发症的患者辅助治疗的时间明显更长（MD，9.44；95%CI，4.07-14.82，P<0.001）。然而，在即刻乳房重建后有伤口并发症和无伤口并发症的患者中，在乳腺癌复发（OR，1.96；95%CI，0.95-4.06，P=0.07）、死亡率（OR，1.95；95%CI，0.89-4.27，P=0.09）和即刻乳房重建的类型（OR，1.01；95%CI，0.53-1.92，P=0.98）方面，无显著差异。伤口并发症辅助治疗的时间明显更长，但在乳腺癌复发、死亡率和即刻乳房重建类型方面无显著差异。即使荟萃分析中未发现低样本量，但在某些比较中发现研究数量较少，因此对结果的分析应谨慎进行。
