A Meta-analysis Comparing Deep Inferior Epigastric Perforator Flaps and Latissimus Dorsi Flaps in Breast Reconstruction

被引:0
作者
Tanas, Yousef [1 ]
Tanas, Julie [1 ]
Swed, Sarya [2 ,3 ]
Spiegel, Aldona J. [4 ]
机构
[1] Alexandria Univ, Fac Med, Alexandria, Egypt
[2] Aleppo Univ, Fac Med, Aleppo, Syria
[3] Damascus Univ, Dept Publ Hlth & Prevent Med, Damascus, Syria
[4] Weill Cornell Med Coll, Houston Methodist Hosp, Inst Reconstruct Surg, Houston, TX USA
关键词
QUALITY-OF-LIFE; DIEP FLAP; COMPLICATIONS; SATISFACTION; MASTECTOMY;
D O I
10.1097/GOX.0000000000006206
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: 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. Methods: 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. Results: 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, P < 0.00001], physical well-being (MD = 5.95, 95% CI = 2.98-8.92, P < 0.0001), and satisfaction with outcome (MD = 9.36, 95% CI = 3.01-15.71, P = 0.004). Nonetheless, DIEP flaps had higher rates of skin flap necrosis [risk ratio (RR) = 4.27, 95% CI = 2.44 to 7.46, P < 0.00001], wound dehiscence (RR = 5.12, 95% CI = 2.53-10.35, P < 0.00001), and reoperation (RR = 2.24, 95% CI = 1.58 -3.16, P < 0.00001) but lower seroma rates (RR = 0.27, 95% CI = 0.10-0.74, P = 0.01). Conclusions: DIEP flap reconstruction offers superior patient satisfaction compared with LD flap reconstruction, despite a higher incidence of certain complications.
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页数:10
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