SAFETY AND BENEFITS OF TISSUE EXPANDER/IMPLANT VERSUS LATISSIMUS DORSI WITH/WITHOUT IMPLANT IN POSTMASTECTOMY BREAST RECONSTRUCTION FOR BREAST CANCER PATIENTS: ASYSTEMATIC REVIEW AND META-ANALYSIS

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.

Automated summary

Comparison of reconstruction procedures for Asian breast cancer patients with small breasts found that latissimus dorsi flaps with/without implant were safer and more satisfying than tissue expander/implant, indicating a good compromise between complication risk and cosmetic outcomes.