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“Implant vs. autologous tissue-based breast reconstruction: a systematic review and meta-analysis of the studies comparing surgical approaches in 55455 patients.”

Published:November 23, 2022DOI:https://doi.org/10.1016/j.bjps.2022.11.044

      ABSTRACT

      Background

      The choice of reconstruction type is of the greatest importance in the process of treating breast cancer. There are two major reconstructive pathways in this group of patients, which include Autologous Breast Reconstruction (ABR) and Implant-based Breast Reconstruction (IBR). The aim of the following systematic review and meta-analysis was to assess and compare IBR vs ABR.

      Methods

      A review of studies reporting the differences between the procedures was performed. The MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, Scopus and Web of Science databases were thoroughly searched in September of 2021. The data concerning group characteristics, BREAST-Q scores, complication rates, Length of Stay (LOS) and costs were extracted. For randomized studies, The Cochrane Risk of Bias Tool was used, while for other types of research - Newcastle-Ottawa Quality Assessment for Cohort Studies.

      Results

      Our meta-analysis included 32 studies (n=55455). We observed significantly better outcomes following ABR when it comes to aesthetic satisfaction (MD: -8.51; 95%CI: -10.70, -6.33; p<0.001) and satisfaction with the entire reconstructive treatment (MD: -6.56; 95%CI -9.97, -3.14; p<0.001). Both methods appeared to be comparable in terms of safety, whilst the complication rates varied insignificantly between the groups (OR: 1.06; 95%CI: 0.71, 1.59; p=0.76). ABR seems to be correlated with significantly higher costs (SMD: -0.69; 95%CI -1.21, -0.17; p=0.010).

      Conclusions

      The results obtained from this evidence-based study will improve the understanding of different clinical pathways that patients can be assigned to. The study emphasized the advantages and disadvantages of both methods.

      Keywords

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