Efficacy of Exclusive Fat Grafting for Breast Reconstruction: An Updated Systematic Review and Meta-analysis.

Autor: Al Qurashi AA; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia., Shah Mardan QNM; Plastic and Reconstructive Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar., Alzahrani IA; College of Medicine, Taibah University, Medina, Saudi Arabia., AlAlwan AQ; Department of Plastic and Reconstructive Surgery, Security Forces Hospital, Riyadh, Saudi Arabia., Bafail A; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia., Alaa Adeen AM; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia., Albahrani A; Department of Plastic and Reconstructive Surgery, King Fahad Hospital, Al Hofuf, Saudi Arabia., Aledwani BN; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia., Halawani IR; College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., AlBattal NZ; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Mrad MA; Plastic and Reconstructive Surgery Section, Department of Surgery, King Faisal Specialist Hospital & Research Centre, P.O. Box 3354, 11211, Riyadh, Saudi Arabia. amirmurad@gmail.com.
Jazyk: angličtina
Zdroj: Aesthetic plastic surgery [Aesthetic Plast Surg] 2024 May 21. Date of Electronic Publication: 2024 May 21.
DOI: 10.1007/s00266-024-03978-3
Abstrakt: Background: Exclusive fat grafting is an alternative method to implant- or flap- based reconstruction techniques following mastectomies or breast conservation therapies. Its efficacy has been explored before but new data has come to light, resulting in previous results becoming outdated. Concerns have also been raised about the oncological safety of this procedure which must be evaluated alongside the efficacy to gain a comprehensive understanding of the merits of this alternative technique.
Methods: We queried the PubMed electronic database from its inception until August 2023 for studies evaluating the efficacy and oncological safety of exclusive fat grafting breast reconstruction following cancer-related mastectomy or breast conservation therapy. Results of the analysis were pooled and presented as means or valid proportions. Results of the analysis were pooled using a random-effects model and presented with 95% confidence intervals (95% CIs) where appropriate.
Results: 41 studies were included in our analysis. Pooled results show that on average, 1.7 sessions of exclusive fat grafting were required to complete reconstruction in Breast Conservation Therapy (BCT) patients, with an average volume of 114.2 ml being injected. For mastectomy patients with irradiated breasts, 4.7 sessions were needed on average with 556.8 ml being required to complete reconstruction, compared to their non-irradiated Counterparts requiring only 2.6 sessions and 207.2 ml to complete reconstruction. Oncological recurrence events were found in 29/583 non-irradiated mastectomy patients (p = 0.014) and in 41/517 BCT patients (p = 0.301) CONCLUSION: Exclusive fat grafting is an oncologically safe and reasonably efficacious alternative to more common methods of breast reconstruction. More data is needed to fully characterize the oncological safety of this procedure in irradiated and non-irradiated mastectomy patients.
Level of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
(© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)
Databáze: MEDLINE
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