| Objective:The purpose of this Meta analysis study was to evaluate the appropriate period of PMRT in two-step breast reconstruction by comparing the effects of different timing of postoperative radiotherapy(PMRT)on reconstruction failure,capsule contraction,postoperative infection,postoperative hematoma,postoperative seroma and postoperative wound dehiscence in two-step breast reconstruction with tissue dilator and permanent prosthesis。Methods:In this study,all the related literatures about the use of PMRT in tissue dilator-permanent prosthesis two-step breast reconstruction were searched in Pubmed,Embase and The Cochrane Library database.The retrieval period was from the establishment of the database to July 2019.The data were analyzed by STATA software(version 12.0)and Review Manager(version 5.3).Random effect model or fixed effect model is used for calculation.Results:This study included 9 related studies,7 retrospective cohort design studies and 2 prospective cohort design studies.The correction results are as follows:PMRT irradiation on permanent prosthesis has a lower failure rate of reconstruction than irradiating on tissue expander(OR=2.32,and 95%CI 1.31-4.10);PMRT 0.0004 irradiation on tissue expander has a lower incidence of severe capsular contracture than irradiation on permanent prosthesis(OR=0.27,and 95%CI 0.18-0.40,P<0.00001).There was no significant difference in postoperative infection,postoperative hematoma,postoperative seroma and postoperative wound dehiscence between the two groups.Conclusion:In the two-step breast reconstruction with tissue dilator and permanent prosthesis,the failure rate of PMRT on permanent prosthesis can be lower,and the rate of capsular contracture can be lower after irradiation on tissue dilator.However,in terms of postoperative infection,postoperative hematoma,postoperative seroma and postoperative wound dehiscence,different timing of radiotherapy has no significant effect on related complications. |
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