Li Ling, Wu Di, Zhu Xiaohai
Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Front Med (Lausanne). 2024 Sep 20;11:1440139. doi: 10.3389/fmed.2024.1440139. eCollection 2024.
This analysis evaluates the efficacy and safety of different flap techniques for Autologous Breast Reconstruction by collecting all clinical trials employing these methods and applying a Bayesian network meta-analysis.
We systematically searched PubMed, Embase, and Web of Science for relevant literature, focusing on outcomes such as total flap loss, donor site wound dehiscence, secondary corrections at the donor site, psychosocial well-being, satisfaction with breasts, and sexual well-being.
Our analysis included 10 clinical studies involving 871 patients across six flap techniques. In terms of total flap loss, the TUG flap showed the highest SUCRA value (89.6%), followed by the TMG flap (64.8%). For donor site wound dehiscence, the DIEP flap ranked highest with a SUCRA value of 60.1%, followed by the PAP flap (48.6%). In secondary corrections at the donor site, the PAP flap was the leader (95.5%), followed by the DIEP flap (52.5%) and the TMG flap (41.4%). For outcomes related to psychosocial well-being, satisfaction with breasts, and sexual well-being, the Four-flap technique consistently ranked highest (81.3, 85.0, and 88.4%, respectively).
Various flap techniques in Autologous Breast Reconstruction each present distinct benefits and risks. The Four-flap technique shows significant advantages in patient satisfaction, while the TUG flap excels in reducing total flap loss.
本分析通过收集所有采用这些方法的临床试验并应用贝叶斯网络荟萃分析,评估不同皮瓣技术用于自体乳房重建的疗效和安全性。
我们系统检索了PubMed、Embase和Web of Science上的相关文献,重点关注皮瓣完全坏死、供区伤口裂开、供区二次修复、心理社会幸福感、乳房满意度和性健康等结果。
我们的分析纳入了10项临床研究,涉及6种皮瓣技术的871例患者。在皮瓣完全坏死方面,臀上动脉穿支皮瓣(TUG皮瓣)的累积排序概率值(SUCRA值)最高(89.6%),其次是横向股薄肌皮瓣(TMG皮瓣,64.8%)。对于供区伤口裂开,腹壁下动脉穿支皮瓣(DIEP皮瓣)的SUCRA值最高,为60.1%,其次是腹壁浅动脉穿支皮瓣(PAP皮瓣,48.6%)。在供区二次修复方面,PAP皮瓣领先(95.5%),其次是DIEP皮瓣(52.5%)和TMG皮瓣(41.4%)。对于心理社会幸福感、乳房满意度和性健康相关的结果,四皮瓣技术始终排名最高(分别为81.3%、85.0%和88.4%)。
自体乳房重建中的各种皮瓣技术各有不同的益处和风险。四皮瓣技术在患者满意度方面显示出显著优势,而TUG皮瓣在减少皮瓣完全坏死方面表现出色。