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新辅助化疗对乳腺癌患者即刻乳房重建术后手术部位伤口感染的影响:一项荟萃分析。

The effect of neoadjuvant chemotherapy on surgical site wound infection after immediate breast reconstruction in patients with breast cancer: A meta-analysis.

作者信息

Zhang Chao, Li Juanjuan, Wang Lin, Sun Siyu, Chen Chunchun

机构信息

Department of Surgical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.

Department of Gastroenterology, Second Affiliated Hospital of Bengbu Medical College, Bengbu, China.

出版信息

Int Wound J. 2024 Jan;21(1):e14337. doi: 10.1111/iwj.14337. Epub 2023 Aug 7.

Abstract

Using a meta-analysis approach, we conducted a comprehensive evaluation of the effect of neoadjuvant chemotherapy (NACT) on the incidence of surgical site wound infection during immediate breast reconstruction (IBR) following breast cancer. The aim was to provide evidence-based support for the prevention of wound surgical site infection during IBR after breast cancer surgery. Relevant literature on the effects of NACT on IBR in patients with breast cancer published up until May 2023, was retrieved from various databases, including PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang databases, and China Biology Medicine Database. Two researchers performed the literature screening, data collection, and quality assessment of the included studies independently. The meta-analysis was conducted using Stata version 17.0. Fourteen studies involving 3401 patients (599 in the intervention group and 2802 in the control group) were included in the analysis. The incidence of surgical site infection in the NACT group was higher than that in the control group, but the difference between the two groups was not statistically significant (7.17% vs. 4.85%, odds ratio: 1.02, 95% confidence interval: 0.70-1.50, p = 0.902). These findings suggest that NACT does not increase the risk of surgical site infection during IBR. However, owing to the variation in sample size and literature quality among the included studies, randomised controlled trials are needed to confirm the safety of IBR in patients receiving neoadjuvant chemotherapy.

摘要

我们采用荟萃分析方法,对新辅助化疗(NACT)对乳腺癌即刻乳房重建(IBR)期间手术部位伤口感染发生率的影响进行了全面评估。目的是为乳腺癌手术后IBR期间预防手术部位伤口感染提供循证支持。从包括PubMed、Cochrane图书馆、EMBASE、中国知网(CNKI)、万方数据库和中国生物医学数据库在内的多个数据库中检索了截至2023年5月发表的关于NACT对乳腺癌患者IBR影响的相关文献。两名研究人员独立进行文献筛选、数据收集和纳入研究的质量评估。使用Stata 17.0进行荟萃分析。分析纳入了14项研究,涉及3401例患者(干预组599例,对照组2802例)。NACT组手术部位感染的发生率高于对照组,但两组之间的差异无统计学意义(7.17%对4.85%,比值比:1.02,95%置信区间:0.70 - 1.50,p = 0.902)。这些发现表明,NACT不会增加IBR期间手术部位感染的风险。然而,由于纳入研究的样本量和文献质量存在差异,需要进行随机对照试验来证实接受新辅助化疗的患者进行IBR的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/249d/10777744/8f642ccc7ecd/IWJ-21-e14337-g003.jpg

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