Complications of Immediate versus Delayed DIEP Reconstruction: A Meta-Analysis of Comparative Studies

Article Article scientifique Revue de la littérature Complications of Immediate versus Delayed DIEP Reconstruction: A Meta-Analysis of Comparative Studies eng 2022-09-01 2022-09-01 author Alves Dos Reis André 0000-0002-4088-5048 808005 author Tan Vincent Sheng 0000-0001-5852-1720 845021 author Scampa Matteo 0000-0003-0461-7596 751050 author Kalbermatten Daniel 948183 Daniel Felix Kalbermatten author Oranges Carlo 0000-0003-1735-5329 955344 4272 10.3390/cancers14174272 36077807 2072-6694 PMC9454956 https://www.mdpi.com/2072-6694/14/17/4272 Purpose: The setting regarding the ideal timing for deep inferior epigastric perforator flap (DIEP) reconstruction remains unclear. Immediate breast reconstruction (IBR) is performed at the same time as mastectomy, while delayed breast reconstruction (DBR) is performed at any time after mastectomy except immediately. We compared both strategies to assess whether IBR or DBR should be performed to reduce postoperative adverse events. Methods: A systematic review of PubMed, Embase, Medline, Cochrane, and Web of Science was conducted, aiming at articles comparing the recipient site outcomes of IBR versus DBR with DIEP. We used the Mantel-Haenszel method with a fixed effects model. Results were expressed as the OR with a 95% CI. Results: Two retrospective and two prospective studies were identified involving 5784 DIEPs (1744 immediate and 4040 delayed). We showed a significant difference in favor of IBR for wound healing issues (OR = 0.57, 95% CI 0.41, 0.77; p = 0.0003). However, no significant differences for hematoma, infection, fat necrosis, partial flap loss, and total flap loss rate were seen. Conclusions: Despite variability in the choice of the ideal time for breast reconstruction and outcomes reported among studies, immediate DIEP surgery appears to be a reliable setting with less delayed healing issues. DIEP Adverse events Autologous reconstruction Delayed breast reconstruction Free flap Immediate breast reconstruction Radiotherapy Surgical timing Dewey 617 57 Département de chirurgie 222 false 1343 Reconstruction chirurgicale et régénération des tissus 1029 Cancers 14 17 912aa6b2-f40b-486d-8ac0-65d73b239341 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 2256603 application/pdf CC BY-4.0 4b716749-bf81-42fb-a129-12a185d90fe0 Appendix Public cancers-14-04272-g001.jpg 38971 image/jpeg Figure 1 c1ce3631-c94d-47d8-b90b-8516b6ab1b51 Appendix Public cancers-14-04272-g002.jpg 58432 image/jpeg Figure 2 02fb9624-7de3-4cf7-b22b-843cdf068ba0 Appendix Public cancers-14-04272-g003.jpg 176047 image/jpeg Figure 3 3cadd0a5-49ce-429b-acd7-bbaf2415e571 Appendix Public cancers-14-04272-g004.jpg 85993 image/jpeg Figure 4 616ca791-3234-478f-b444-21e46638e0db Appendix Public cancers-14-04272-g005.jpg 26061 image/jpeg Figure 5 openAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Complications of Immediate versus Delayed DIEP Reconstruction: A Meta-Analysis of Comparative Studies	Cancers			2022	162	637

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Alves Dos Reis, André