Perforator mapping reduces the operative time of DIEP flap breast reconstruction: A systematic review and meta-analysis of preoperative ultrasound, computed tomography and magnetic resonance angiography
| Autor: | Justin C.R. Wormald, James Watford, Ryckie G. Wade, Andrea Figus, Russell J. Bramhall |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography Mammaplasty Operative Time 030230 surgery Magnetic resonance angiography Abdominal wall 03 medical and health sciences 0302 clinical medicine DIEP flap medicine Humans cardiovascular diseases Computed tomography angiography medicine.diagnostic_test business.industry Abdominal Wall Ultrasound Epigastric Arteries Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Meta-analysis Angiography Female Ultrasonography Mammary Radiology business Breast reconstruction Perforator Flap Magnetic Resonance Angiography |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery. 71:468-477 |
| ISSN: | 1748-6815 |
| Popis: | Background: Prior to DIEP flap breast reconstruction, mapping the perforators of the lower abdominal wall using ultrasound, computed tomography angiography (CTA) or magnetic resonance angiography (MRA) reduces the risk of flap failure. This review aimed to investigate the additional potential benefit of a reduction in operating time. Methods: We systematically searched the literature for studies concerning adult women undergoing DIEP flap breast reconstruction, which directly compared the operating times and adverse outcomes for those with and without preoperative perforator mapping by ultrasound, CTA or MRA. Outcomes were extracted, data meta-analysed and the quality of the evidence appraised. Results: Fourteen articles were included. Preoperative perforator mapping by CTA or MRA significantly reduced operating time (mean reduction of 54 minutes [95% CI 3, 105], p = 0.04), when directly compared to DIEP flap breast reconstruction with no perforator mapping. Further, perforator mapping by CTA was superior to ultrasound, as CTA saved more time in theatre (mean reduction of 58 minutes [95% CI 25, 91], p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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