Yunzhu Li1, Gang Xu2, Nanze Yu1, Jiuzuo Huang1, Xiao Long1. 1. From the Department of Plastic and Reconstructive Surgery. 2. Department of Liver Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Abstract
BACKGROUND: There is currently no consensus on the ideal plane for implant placement in breast reconstruction. The study compares the clinical efficacy and safety between prepectoral and subpectoral implant-based breast reconstruction. METHODS: PubMed, Web of Sciences, EMBASE, and Cochrane databases were systematically searched following the PRISMA guidelines. Inclusion criteria were articles describing implant-based breast reconstructions with implant placed either prepectorally or subpectorally. Primary outcomes were postoperative complications, pain score, and patients' quality of life. RESULTS: There were 15 studies including a total of 1868 patients. Overall complication rates were comparable between the prepectoral and subpectoral groups (odds ratio [OR], 0.79; confidence interval [CI], 0.57-1.10). The capsular contracture rate was reduced in the prepectoral group (OR, 0.45; CI, 0.27-0.73), whereas no significant difference was observed in terms of skin necrosis (OR, 0.72; CI, 0.45-1.17), implant loss (OR, 0.85; CI, 0.56-1.30), and patients' quality of life (standardised mean difference, 0.25; CI, -0.51 to 1.00). CONCLUSION: The prepectoral implant-based breast reconstruction is a good alternative to subpectoral implant-based breast reconstruction for a certain group of patients, eliminating animation deformity without increasing complications.
BACKGROUND: There is currently no consensus on the ideal plane for implant placement in breast reconstruction. The study compares the clinical efficacy and safety between prepectoral and subpectoral implant-based breast reconstruction. METHODS: PubMed, Web of Sciences, EMBASE, and Cochrane databases were systematically searched following the PRISMA guidelines. Inclusion criteria were articles describing implant-based breast reconstructions with implant placed either prepectorally or subpectorally. Primary outcomes were postoperative complications, pain score, and patients' quality of life. RESULTS: There were 15 studies including a total of 1868 patients. Overall complication rates were comparable between the prepectoral and subpectoral groups (odds ratio [OR], 0.79; confidence interval [CI], 0.57-1.10). The capsular contracture rate was reduced in the prepectoral group (OR, 0.45; CI, 0.27-0.73), whereas no significant difference was observed in terms of skin necrosis (OR, 0.72; CI, 0.45-1.17), implant loss (OR, 0.85; CI, 0.56-1.30), and patients' quality of life (standardised mean difference, 0.25; CI, -0.51 to 1.00). CONCLUSION: The prepectoral implant-based breast reconstruction is a good alternative to subpectoral implant-based breast reconstruction for a certain group of patients, eliminating animation deformity without increasing complications.
Authors: Yunzhu Li; Xiaojun Wang; Jørn Bo Thomsen; Maurice Y Nahabedian; Naohiro Ishii; Warren M Rozen; Xiao Long; Yuh-Shan Ho Journal: Ann Transl Med Date: 2020-11
Authors: Vladimir Mégevand; Matteo Scampa; Helen McEvoy; Daniel F Kalbermatten; Carlo M Oranges Journal: Cancers (Basel) Date: 2022-08-30 Impact factor: 6.575