Flap fixation in preventing seroma formation after mastectomy: an updated meta-analysis

被引:18
作者
Velotti, Nunzio [1 ]
Limite, Gennaro [1 ]
Vitiello, Antonio [1 ]
Berardi, Giovanna [1 ]
Musella, Mario [1 ]
机构
[1] Univ Naples Federico II, Dept Adv Biomed Sci, Via Pansini 5, I-80131 Naples, Italy
关键词
Mastectomy; Flap fixation; Seroma; Flap quilting; BREAST-CANCER; DEAD SPACE; AXILLARY DISSECTION; PUBLICATION; SEQUELAE; CLOSURE; TRIAL;
D O I
10.1007/s13304-021-01049-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
Seroma formation following mastectomy is one of the most experienced complications, with a very variable incidence ranging from 3 to 90%. In recent years, many publications have been realized to define an effective technique to prevent its formation and several approaches have been proposed. Given the potential of flap fixation in reducing seroma formation, we performed a meta-analysis of the literature to investigate the role of this approach as definitive gold standard in mastectomy surgery. Inclusion criteria regarded all studies reporting on breast cancer patients undergoing mastectomy with or without axillary lymph node dissection; studies that compared mastectomy with flap fixation to mastectomy without flap fixation were selected. Papers were eligible for inclusion if outcome was described in terms of seroma formation. As secondary outcome, also surgical site infection (SSI) was evaluated. The included studies were 12, involving 1887 female patients: 221/986 (22.41%) patients experienced seroma formation after flap fixation and 393/901 (43.61%) patients had this complication not receiving flap fixation, with a significant statistical difference between the two groups (OR = 0.267, p = 0.001, 95% CI 0.153, 0.464). About, SSI 59/686 (8.6%) in flap fixation group and 67/686 (9.7%) in patients without flap fixation, with no statistical differences between groups (OR = 0.59, p = 0.056, 95% CI 0.344, 1.013). The heterogeneity between included studies does not allow us to reach definitive conclusions but only to suggest the strong evaluation of this approach after mastectomy in seroma preventing and SSI reduction.
引用
收藏
页码:1307 / 1314
页数:8
相关论文
共 26 条
[1]   Concepts of seroma formation and prevention in breast cancer surgery [J].
Agrawal, Amit ;
Ayantunde, Abraham Abiodun ;
Cheung, Kwok Leung .
ANZ JOURNAL OF SURGERY, 2006, 76 (12) :1088-1095
[2]   Flap Anchoring Following Primary Breast Cancer Surgery Facilitates Early Hospital Discharge and Reduces Costs [J].
Almond, Laurence M. ;
Khodaverdi, Laura ;
Kumar, Belindra ;
Coveney, Eamonn C. .
BREAST CARE, 2010, 5 (02) :97-101
[3]   Systematic review and meta-analysis of the use of fibrin sealant to prevent seroma formation after breast cancer surgery [J].
Carless, P. A. ;
Henry, D. A. .
BRITISH JOURNAL OF SURGERY, 2006, 93 (07) :810-819
[4]   Reducing Seroma Formation and Its Sequelae After Mastectomy by Closure of the Dead Space: A Multi-center, Double-Blind Randomized Controlled Trial (SAM-Trial) [J].
de Rooij, L. ;
van Kuijk, S. M. J. ;
Granzier, R. W. Y. ;
Hintzen, K. F. H. ;
Heymans, C. ;
Theunissen, L. L. B. ;
von Meyenfeldt, E. M. ;
van Essen, J. A. ;
van Haaren, E. R. M. ;
Janssen, A. ;
Vissers, Y. L. J. ;
Beets, G. L. ;
van Bastelaar, J. .
ANNALS OF SURGICAL ONCOLOGY, 2021, 28 (05) :2599-2608
[5]   Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis [J].
Duval, S ;
Tweedie, R .
BIOMETRICS, 2000, 56 (02) :455-463
[6]   Flap adhesion and effect on postoperative complication rates using Tissuglu® in mastectomy patients [J].
Eichler, Christian ;
Fischer, Petra ;
Sauerwald, Axel ;
Dahdouh, Faten ;
Warm, Mathias .
BREAST CANCER, 2016, 23 (03) :486-490
[7]  
Gonzalez Ernest A, 2003, Breast J, V9, P385, DOI 10.1046/j.1524-4741.2003.09504.x
[8]   Reducing seroma formation and its sequelae after mastectomy by closure of the dead space: The interim analysis of a multi-center, double-blind randomized controlled trial (SAM trial) [J].
Granzier, Renee W. Y. ;
van Bastelaar, James ;
van Kuijk, Sander M. J. ;
Hintzen, Kim F. H. ;
Heymans, Cathelijne ;
Theunissen, Lotte L. B. ;
van Haaren, Els R. M. ;
Janssen, Alfred ;
Beets, Geerard L. ;
Vissers, Yvonne L. J. .
BREAST, 2019, 46 :81-86
[9]   Seroma formation after surgery for breast cancer [J].
Hashemi E. ;
Kaviani A. ;
Najafi M. ;
Ebrahimi M. ;
Hooshmand H. ;
Montazeri A. .
World Journal of Surgical Oncology, 2 (1)
[10]   Measuring inconsistency in meta-analyses [J].
Higgins, JPT ;
Thompson, SG ;
Deeks, JJ ;
Altman, DG .
BMJ-BRITISH MEDICAL JOURNAL, 2003, 327 (7414) :557-560