Tanas Yousef, Tanas Julie, Swed Sarya, Spiegel Aldona J
From the Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Faculty of Medicine, Aleppo University, Aleppo, Syria.
Plast Reconstr Surg Glob Open. 2024 Oct 9;12(10):e6206. doi: 10.1097/GOX.0000000000006206. eCollection 2024 Oct.
Deep inferior epigastric perforator (DIEP) flaps and latissimus dorsi (LD) flaps are two widely used breast reconstruction techniques, each with distinct advantages and limitations. This meta-analysis aims to compare patient satisfaction and incidence of complications between these two techniques to inform clinical decision-making.
PubMed, Scopus, and Web of Science were searched for relevant studies. We included studies with data comparing DIEP and LD flaps, BREAST-Q patient satisfaction, and complications. Statistical analyses were performed using RevMan 5.4.
The search yielded 788 studies, of which 13 were included in the meta-analysis. A total of 2128 patients were analyzed, with 1378 undergoing DIEP flap reconstruction and 750 receiving LD flap reconstruction. The analysis showed greater improvement with DIEP flaps in breast satisfaction [mean difference (MD) = 9.48, 95% confidence interval (CI) = 6.90-12.05, < 0.00001], physical well-being (MD = 5.95, 95% CI = 2.98-8.92, < 0.0001), and satisfaction with outcome (MD = 9.36, 95% CI = 3.01-15.71, = 0.004). Nonetheless, DIEP flaps had higher rates of skin flap necrosis [risk ratio (RR) = 4.27, 95% CI = 2.44 to 7.46, < 0.00001], wound dehiscence (RR = 5.12, 95% CI = 2.53-10.35, < 0.00001), and reoperation (RR = 2.24, 95% CI = 1.58 -3.16, < 0.00001) but lower seroma rates (RR = 0.27, 95% CI = 0.10-0.74, = 0.01).
DIEP flap reconstruction offers superior patient satisfaction compared with LD flap reconstruction, despite a higher incidence of certain complications.
腹壁下深动脉穿支（DIEP）皮瓣和背阔肌（LD）皮瓣是两种广泛应用的乳房重建技术，每种技术都有其独特的优缺点。本荟萃分析旨在比较这两种技术在患者满意度和并发症发生率方面的差异，为临床决策提供依据。
检索PubMed、Scopus和Web of Science数据库中的相关研究。纳入比较DIEP皮瓣和LD皮瓣、BREAST-Q患者满意度及并发症的数据研究。使用RevMan 5.4进行统计分析。
检索共得到788项研究，其中13项纳入荟萃分析。共分析了2128例患者，其中1378例行DIEP皮瓣重建，750例行LD皮瓣重建。分析显示，DIEP皮瓣在乳房满意度[平均差（MD）=9.48，95%置信区间（CI）=6.90-12.05，P<0.00001]、身体健康（MD=5.95，95%CI=2.98-8.92，P<0.0001）和对结果的满意度（MD=9.36，95%CI=3.01-15.71，P=0.004）方面有更大改善。然而，DIEP皮瓣的皮瓣坏死率[风险比（RR）=4.27，95%CI=2.44至7.46，P<0.00001]、伤口裂开率（RR=5.12，95%CI=2.53-10.35，P<0.00001）和再次手术率（RR=2.24，95%CI=1.58-3.16，P<0.00001）较高，但血清肿发生率较低（RR=0.27，95%CI=0.10-0.74，P=0.01）。
尽管某些并发症发生率较高，但与LD皮瓣重建相比，DIEP皮瓣重建能提供更高的患者满意度。
