Safety of prepectoral breast reconstruction after mastectomies: a single-arm meta-analysis

• 作者: Linlin Guo Jian Liu Bei Qian Jiaming Sun Yun Xia Nengqiang Guo Ran An Ke Guo Xiaoling Feng
• 来源期刊: 整形与美容研究（英文版）
• 年，卷（期）: 2021,（5）
• 所属期刊栏目: Meta-Analysis
• 页码范围: 45-57
• 页数: 13页
• 语种: 英文
• DOI: 10.20517/2347-9264.2021.18

摘要

Aim: Currently, prepectoral breast reconstruction (PBR) is widely used in clinical practice, but its safety lacks high-level epidemiological evidence. This meta-analysis intended to clarify the safety of PBR for clinicians. Methods: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two independent reviewers systematically searched six databases from 1 January 2000 to 27 March 2020 to identify eligible studies. Statistical analysis was performed using R GUI 3.6.3, and a random effects model was used to calculate the proportion with 95％ confidence intervals (CIs). Subgroup analysis was conducted based on body mass index, proportion of patients receiving preoperative radiotherapy, surgical technique, and follow-up time. Results: In total, 19 studies involving 1686 cases and 2551 breasts were included. The percentage of surgical success was 96.2％, while the total complication rate was 15.4％ (95％CI: 10.6％-20.9％), hematoma rate was 4.3％ (95％CI: 2.3％-6.9％), infection rate was 3.4％ (95％CI: 2.0％-5.1％), and capsular contracture rate was 0.9％ (95％CI: 0.1％-2.6％). The results of the subgroup analysis show that: (1) the incidence of capsular contracture was higher in patients with lower weight, while other complications were minimal; (2) compared with the patients who underwent two-stage expander-assisted PBR, those with direct to-implant PBR had lower incidences of surgical complications; (3) preoperative radiotherapy could be a risk factor for various postoperative complications; and (4) with the extension of follow-up time, the incidence of long-term complications increases. Conclusion: This present work confirmed that PBR is a safe and reliable therapy with a higher success rate and a relatively lower rate of complications. Overall, PBR can be used as an alternative for sub-pectoral breast reconstruction.