A Systematic Review of Single-Stage Augmentation-Mastopexy
A Systematic Review of Single-Stage Augmentation-Mastopexy
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DOI：
10.1097/prs.0000000000000582
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发表时间：
2014-11-01
影响因子：
3.6
通讯作者：
Kim, John Y. S.
中科院分区：
文献类型：
--
作者：
Khavanin, Nima;Jordan, Sumanas W.;Kim, John Y. S.
背景：考虑到增加乳房体积和减少皮肤包膜的双重目的，单期隆乳术的安全性仍然存在争议。目前，相关文献相对较少，异质性较大。本系统综述考虑了并发症概况和汇总汇总估计，试图指导手术决策。方法：通过多个数据库查询隆胸-乳房隆乳联合手术的结果。尽可能进行并发症发生率的荟萃分析。结果：23项研究符合纳入标准。平均随访时间从16周到173周不等，大多数不到1年。合并总并发症发生率为13.1% （95% CI, 6.7 ~ 21.3%）。最常见的个体并发症是复发性上睑下垂，发生率为5.2% (95% CI， 3.1%至7.8%)，其次是不良疤痕（3.7%;95% CI， 1.9%至6.1%）。包膜挛缩和组织相关不对称的合并发生率分别为3.0% （95% CI, 1.4 - 5.0%）和2.9% （95% CI, 1.2 - 5.4%）。感染、血肿和血肿是罕见的，每个的总发病率低于2%。三项已发表的研究报告了患者满意度的数据。13项研究的再手术率为10.7% （95% CI, 6.7 ~ 15.4%）。结论：该荟萃分析包括4856例同时隆胸-乳房切除术。由于手术技术、结果定义和随访时间的差异，研究异质性很高。这篇综述表明，通过谨慎的患者选择，单期乳房隆胸术的合并并发症和再手术率是可以接受的低。
Background: The safety of single-stage augmentation-mastopexy remains controversial given the dual purpose of increasing breast volume and decreasing the skin envelope. Currently, the literature is relatively sparse and heterogeneous. This systematic review considered complication profiles and pooled summary estimates in an attempt to guide surgical decision-making.Methods: Multiple databases were queried for combined augmentation-mastopexy outcomes. Whenever possible, meta-analysis of complication rates was performed.Results: Twenty-three studies met inclusion criteria. Average follow-up varied from 16 to 173 weeks, with a majority under 1 year. The pooled total complication rate was 13.1 percent (95 percent CI, 6.7 to 21.3 percent). The most common individual complication was recurrent ptosis, with an incidence of 5.2 percent (95 percent CI, 3.1 to 7.8 percent), followed by poor scarring (3.7 percent; 95 percent CI, 1.9 to 6.1 percent). The pooled incidences of capsular contracture and tissue-related asymmetry were 3.0 percent (95 percent CI, 1.4 to 5.0 percent) and 2.9 percent (95 percent CI, 1.2 to 5.4 percent), respectively. Infection, hematoma, and seroma were rare, with pooled incidences of less than 2 percent each. Three published studies reported data on patient satisfaction. The reoperation rate obtained from 13 studies was 10.7 percent (95 percent CI, 6.7 to 15.4 percent).Conclusions: This meta-analysis encompassed 4856 cases of simultaneous augmentation-mastopexy. Study heterogeneity was high because of differences in surgical techniques, outcome definitions, and follow-up durations. This review suggests that with careful patient selection, pooled complication and reoperation rates for single-stage augmentation-mastopexy are acceptably low.