Jeong Woonhyeok, Choi Jaehoon, Kim Junhyung, Son Daegu, Jo Taehee
Department of Plastic and Reconstructive Surgery, Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of Korea.
J Clin Med. 2025 Aug 3;14(15):5461. doi: 10.3390/jcm14155461.
Breast reconstruction post-mastectomy has increasingly emphasized the importance of sensory restoration. This study aimed to evaluate the comparative efficacy of anterior versus lateral cutaneous intercostal nerve branches in neurotization during abdominal-based autologous breast reconstruction. Through a systematic literature search and meta-analysis, we reviewed studies published between January 2003 and August 2023. Our methods involved categorizing studies based on the nerve branch used, extracting relevant data, and conducting a quality assessment. To determine the difference in the magnitude of sensory recovery, a meta-analysis was conducted to pool the effect sizes (mean differences) from individual studies. Given the potential for heterogeneity across studies, a random-effects model was employed using the DerSimonian and Laird method. Subgroup analysis was then performed to separately evaluate the effect sizes for the anterior and lateral groups. We identified five studies for the anterior group and five studies for the lateral group. The anterior group included a total of 225 non-neurotized and 240 neurotized breasts, while the lateral group consisted of 62 non-neurotized and 51 neurotized breasts. The anterior group exhibited superior sensory recovery compared to the lateral group ( = 0.08 for the common effect model). The result was borderline significant, suggesting a trend towards a difference between the two groups. In terms of patient-reported outcomes, the anterior group provided data, while the lateral group lacked such data, underscoring a potential research gap. Results indicated a trend favoring the anterior cutaneous branch, with studies showing improved sensory outcomes and patient satisfaction. However, the choice between the two should be individualized, considering the patient's unique needs and the surgeon's expertise.
乳房切除术后的乳房重建越来越强调感觉恢复的重要性。本研究旨在评估在基于腹部的自体乳房重建中，前侧与外侧肋间皮神经分支在神经化过程中的相对疗效。通过系统的文献检索和荟萃分析，我们回顾了2003年1月至2023年8月期间发表的研究。我们的方法包括根据所使用的神经分支对研究进行分类、提取相关数据并进行质量评估。为了确定感觉恢复程度的差异，我们进行了荟萃分析，以汇总各个研究的效应量（平均差异）。鉴于各研究之间存在异质性的可能性，我们采用了DerSimonian和Laird方法的随机效应模型。然后进行亚组分析，以分别评估前侧组和外侧组的效应量。我们确定了前侧组的5项研究和外侧组的5项研究。前侧组共有225个未进行神经化的乳房和240个进行了神经化的乳房，而外侧组由62个未进行神经化的乳房和51个进行了神经化的乳房组成。与外侧组相比，前侧组表现出更好的感觉恢复（共同效应模型下 = 0.08）。结果接近显著，表明两组之间存在差异趋势。在患者报告的结果方面，前侧组提供了数据，而外侧组缺乏此类数据，这凸显了一个潜在的研究空白。结果表明倾向于前侧皮神经分支的趋势，研究显示感觉结果和患者满意度有所改善。然而，在两者之间的选择应根据患者的独特需求和外科医生的专业知识进行个体化。
