Benefit of the Omental Flap in Breast Reconstruction for Oncoplastic Treatment: A Systematic Review and Single-Arm Meta-Analysis

Liehao Yang; Chen Tao; Yan Yan; Lingfeng Pan; Caihong Li; Xiaoyu Jin; Jiao Kong; Zhuoxia Wu

doi:10.1007/s00266-024-04638-2

Benefit of the Omental Flap in Breast Reconstruction for Oncoplastic Treatment: A Systematic Review and Single-Arm Meta-Analysis

Aesthetic Plast Surg. 2024 Dec 24. doi: 10.1007/s00266-024-04638-2. Online ahead of print.

Authors

Liehao Yang^{1

2}, Chen Tao³, Yan Yan⁴, Lingfeng Pan⁵, Caihong Li⁶, Xiaoyu Jin¹, Jiao Kong¹, Zhuoxia Wu⁷

Affiliations

¹ Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun City, 130033, Jilin Province, China.
² Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun City, 130033, Jilin Province, China.
³ School of Mathematics and Statistics, Northeast Normal University, Changchun City, 130024, Jilin Province, China. taoc387@nenu.edu.cn.
⁴ Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun City, 130033, Jilin Province, China.
⁵ Experimental Plastic Surgery, Clinic for Plastic, Reconstructive and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, D-81675, Munich, Germany.
⁶ Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg, Hartmannstr.14, 91054, Erlangen, Germany.
⁷ Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun City, 130033, Jilin Province, China. wuzhuoxia90@jlu.edu.cn.

PMID: 39718627
DOI: 10.1007/s00266-024-04638-2

Abstract

Background: Oncoplastic surgery for breast cancer patients poses the challenge of achieving optimal aesthetic outcomes without increasing the risk of complications. Omental flap has emerged as n reconstructive option in breast surgery, yet the efficacy and safety of large omental flaps remain uncertain. This study aims to conduct a systematic review and single-arm meta-analysis to comprehensively evaluate the effectiveness, safety, and cosmetic outcomes of large omental flap breast reconstruction, providing updated evidence for clinical practice.

Methods: We systematically searched Embase, PubMed, Cochrane Library, and CNKI databases until August 2023. Studies were screened using inclusion and exclusion criteria. The quality of each study was evaluated with the Newcastle-Ottawa Scale. Meta-analysis was performed using R version 4.2.0.

Results: A total of 22 studies with 1031 patients were reviewed and analyzed. Meta-analysis results showed that hematoma and seroma rate were 4.1% (95%CI 0.8-8.8, P < 0.01). The pooled cosmetic outcomes demonstrated excellent rate 56.7% (95%CI 46.4-69.3, P < 0.01), good rate 7.9% (95%CI 3.9-11.9, P < 0.01), fair rate 28.7% (95%CI 19.9-37.5, P < 0.01). The pooled blood loss was 110.74 ml (95%CI: 72.33-149.14, P = 0), hospital stays was 7.27 (95%CI 5.65-8.89, P < 0.01), the time of omental flap harvest was 65.63 min (95%CI 59.95-71.32, P < 0.01), the time for surgery was 240.87 min (95%CI 5.65- 8.89, P = 0).

Conclusions: This meta-analysis indicates that the omental flap in breast reconstruction is safe and effective with good cosmetic outcomes and a low incidence of complications. The study highlights the benefits of comprehensive assessment, warranting further investigation through high-quality studies and long-term follow-up.

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 .

Keywords: Aesthetic benefit; Breast reconstruction; Omental flap transfer; Omentum; Plastic surgery.

Abstract

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