Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis
Background:. Previous studies have shown a higher complication rate in bilateral (BL) compared to unilateral (UL) deep inferior epigastric perforator (DIEP) flap breast reconstructions. This systematic review and meta-analysis aimed to offer an update by including recent studies to thoroughly assess...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-12-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006359 |
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| author | Boran Tekdogan, MS Jérôme Martineau, MD Daniel F. Kalbermatten, MD, PhD Carlo M. Oranges, MD, PhD |
| author_facet | Boran Tekdogan, MS Jérôme Martineau, MD Daniel F. Kalbermatten, MD, PhD Carlo M. Oranges, MD, PhD |
| author_sort | Boran Tekdogan, MS |
| collection | DOAJ |
| description | Background:. Previous studies have shown a higher complication rate in bilateral (BL) compared to unilateral (UL) deep inferior epigastric perforator (DIEP) flap breast reconstructions. This systematic review and meta-analysis aimed to offer an update by including recent studies to thoroughly assess the complication rates in UL versus BL DIEP flap reconstructions and provide clear guidance for clinicians and their patients.
Methods:. A systematic review of the literature and comparative meta-analysis were performed to assess the differences in complication rates between UL and BL procedures. Only comparative studies that reported on postoperative complications after UL and BL DIEP flap breast reconstructions were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model.
Results:. Five studies representing 5120 patients who underwent either UL or BL DIEP flap breast reconstructions were included. BL DIEP flap reconstructions were associated with a higher risk of total flap loss, with an OR of 1.48 (95% CI, 1.02–2.14) and a P value of 0.04. Conversely, the risk of reexploration surgery was reduced, with an OR of 0.68 (95% CI, 0.55– 0.84) and a P value of 0.0002.
Conclusions:. BL DIEP flap breast reconstruction carries a higher risk of complete flap loss compared with UL reconstructions, with a moderate risk increase. Despite this increased risk, the significant benefits of BL reconstruction make it a viable and recommended option for women requiring this type of surgery. |
| format | Article |
| id | doaj-art-cfe1be2aad7045a59d7d2fe36e9aa991 |
| institution | DOAJ |
| issn | 2169-7574 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-cfe1be2aad7045a59d7d2fe36e9aa9912025-08-20T02:39:56ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-12-011212e635910.1097/GOX.0000000000006359202412000-00009Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysisBoran Tekdogan, MS0Jérôme Martineau, MD1Daniel F. Kalbermatten, MD, PhD2Carlo M. Oranges, MD, PhD3From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.Background:. Previous studies have shown a higher complication rate in bilateral (BL) compared to unilateral (UL) deep inferior epigastric perforator (DIEP) flap breast reconstructions. This systematic review and meta-analysis aimed to offer an update by including recent studies to thoroughly assess the complication rates in UL versus BL DIEP flap reconstructions and provide clear guidance for clinicians and their patients. Methods:. A systematic review of the literature and comparative meta-analysis were performed to assess the differences in complication rates between UL and BL procedures. Only comparative studies that reported on postoperative complications after UL and BL DIEP flap breast reconstructions were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Results:. Five studies representing 5120 patients who underwent either UL or BL DIEP flap breast reconstructions were included. BL DIEP flap reconstructions were associated with a higher risk of total flap loss, with an OR of 1.48 (95% CI, 1.02–2.14) and a P value of 0.04. Conversely, the risk of reexploration surgery was reduced, with an OR of 0.68 (95% CI, 0.55– 0.84) and a P value of 0.0002. Conclusions:. BL DIEP flap breast reconstruction carries a higher risk of complete flap loss compared with UL reconstructions, with a moderate risk increase. Despite this increased risk, the significant benefits of BL reconstruction make it a viable and recommended option for women requiring this type of surgery.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006359 |
| spellingShingle | Boran Tekdogan, MS Jérôme Martineau, MD Daniel F. Kalbermatten, MD, PhD Carlo M. Oranges, MD, PhD Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis Plastic and Reconstructive Surgery, Global Open |
| title | Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis |
| title_full | Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis |
| title_fullStr | Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis |
| title_short | Unilateral Versus Bilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review and Meta-analysis |
| title_sort | unilateral versus bilateral deep inferior epigastric perforator flap breast reconstruction a systematic review and meta analysis |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006359 |
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