Shuting Qin1, Bojie Lin1, Jun Ye1, Shiding Lu1, Yuyong Yan1, Jing Xu2, Guangqiang Ye2, Guoqian Yin1, *
1Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, P.R. China - 2Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University,Nanning,P.R. China
Aims: The study reviewed relevant publications of reconstruction procedure for Asian breast cancer patients with small breasts, and compared postoperative safety and effect outcomes between tissue expander/implant and latissimus dorsi (LD) flaps with/without implant reconstruction.
Methods: Public databases were systematically searched to compare tissue expander/implant against LD flaps with/without implant reconstruction. Three reviewers independently screened all reports and selected the relevant articles using specific inclusion criteria. Data were extracted from the relevant articles using a standardized abstraction form.
Results: Twelve studies were identified. Significant differences were found between the two approaches. Recipients of LD flaps with/without implant reconstruction had lower risks of surgical-site infections (OR, 0.60; 95% CI, 0.38 to 0.95), lower capsular contracture rates (OR, 0.69; 95% CI, 0.48 to 0.98), were less likely to suffer from reconstructive failure(OR, 0.38; 95% CI, 0.14 to 1.04), and were less likely to have reconstructive reoperation (OR, 0.30; 95% CI, 0.12 to 0.73).Recipients of LD flaps with/without implant reconstruction tended to be esthetically more satisfied than women receiving tissue expander/implant(OR, 2.96; 95% CI, 1.01 to 8.71).For patient satisfaction, no significant difference in the pooled estimates was observed (OR, 0.66; 95% CI, 0.22 to 1.95).Studies were of low to moderate quality according to the Newcastle-Ottawa scale.
Conclusions: Thmeta-analysis suggests that LD myocutaneous flap is a good compromise between complication risk and good cosmetic. It is a reliable technique that can be considered as the primary choice for breast reconstruction for Asian women with small- to medium-sized breasts.
Tissue expander/implant, latissimus dorsi with/without implant, mastectomy, breast reconstruction, meta-analysis.