Scientific article
Open access

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

Published inCancers, vol. 14, no. 17, 4272
Publication date2022-09-01
First online date2022-09-01

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
Citation (ISO format)
ALVES DOS REIS, André et al. Complications of Immediate versus Delayed DIEP Reconstruction: A Meta-Analysis of Comparative Studies. In: Cancers, 2022, vol. 14, n° 17, p. 4272. doi: 10.3390/cancers14174272
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ISSN of the journal2072-6694

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