Zheng Caihong, Liu Jiameng, Wen Yahui, Lin Shunguo, Han Hui, Xu Chunsen
The Graduate School of Fujian Medical University, Fuzhou, China.
Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Front Surg. 2023 Jan 9;9:1019950. doi: 10.3389/fsurg.2022.1019950. eCollection 2022.
Prepectoral breast reconstruction has once again appealed, which attributes to the introduction of acellular dermal matrices (ADMs) and mesh. Postmastectomy radiation therapy (PMRT), meanwhile, is crucial in the whole course of treatment for breast cancer patients with lymph node-positive. The impact of PMRT on outcomes after prepectoral breast reconstruction has not been clearly defined to date. This study aimed to compare the impact of PMRT on outcomes after prepectoral vs. subpectoral breast reconstruction.
A comprehensive research on databases including PubMed, Embase, and Cochrane libraries was performed to retrieve literature pertaining to prepectoral breast reconstruction from database inception to October 2021. All included studies evaluated the impact of PMRT on outcomes after breast reconstruction. Only studies comparing patients who underwent prepectoral breast reconstruction with a control group who underwent subpectoral breast reconstruction were included. Data were analyzed using RevMan version 5.2.
A total of 4 studies were included in the meta-analysis, with a total of 394 breasts. In the setting of postmastectomy radiation therapy, 164 breasts were reconstructed with a prepectoral approach, whereas the remaining 230 breasts underwent subpectoral reconstruction. Overall, outcomes between PBR and SBR was no statistical significance in the overall complications (OR: 1.30, 95% CI: 0.35-4.85), infection (OR: 1.62, 95% CI: 0.90-2.91), seroma (OR: 1.60, 95% CI: 0.48-5.27), skin flap necrosis (OR: 0.77, 95% CI: 0.17-3.45), hematoma (OR: 0.38, 95% CI: 0.10-1.41), wound dehiscence (OR: 0.82, 95% CI: 0.36-1.85). But, included studies lacked data about the patient quality of life and satisfaction with the outcome of the reconstructed breast.
In the setting of postmastectomy radiation therapy, prepectoral breast reconstruction is a safe and effective option.
胸前区乳房重建再次受到关注，这归因于脱细胞真皮基质（ADM）和网片的引入。与此同时，乳房切除术后放疗（PMRT）在淋巴结阳性乳腺癌患者的整个治疗过程中至关重要。迄今为止，PMRT对胸前区乳房重建术后结局的影响尚未明确界定。本研究旨在比较PMRT对胸前区与胸肌下乳房重建术后结局的影响。
对包括PubMed、Embase和Cochrane图书馆在内的数据库进行全面检索，以获取从数据库建立至2021年10月有关胸前区乳房重建的文献。所有纳入研究均评估了PMRT对乳房重建术后结局的影响。仅纳入比较接受胸前区乳房重建的患者与接受胸肌下乳房重建的对照组患者的研究。使用RevMan 5.2版进行数据分析。
荟萃分析共纳入4项研究，共394个乳房。在乳房切除术后放疗的情况下，164个乳房采用胸前区入路重建，其余230个乳房采用胸肌下入路重建。总体而言，胸前区乳房重建（PBR）和胸肌下乳房重建（SBR）在总体并发症（OR：1.30，95%CI：0.35 - 4.85）、感染（OR：1.62，95%CI：0.90 - 2.91）、血清肿（OR：1.60，95%CI：0.48 - 5.27）、皮瓣坏死（OR：0.77，95%CI：0.17 - 3.45）、血肿（OR：0.38，95%CI：0.10 - 1.41）、伤口裂开（OR：0.82，95%CI：0.36 - 1.85）方面的结局无统计学意义。但是，纳入研究缺乏关于患者生活质量和对重建乳房结局满意度的数据。
在乳房切除术后放疗的情况下，胸前区乳房重建是一种安全有效的选择。
