A systematic review of randomised controlled trials in breast reconstruction.

IF 1 4区医学 Q3 ORTHOPEDICS

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-05-15 DOI:10.2340/jphs.v59.40087

Emma Hansson, Camilla Larsson, Alexandra Uusimäki, Karolina Svensson, Emmelie Widmark Jensen, Anna Paganini

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引用次数: 0

Abstract

Background: For preference sensitive treatments, such as breast reconstructions, there are barriers to conducting randomised controlled trials (RCTs). The primary aims of this systematic review were to investigate what type of research questions are explored by RCTs in breast reconstruction, where have they been performed and where have they been published, and to thematise the research questions and thus create an overview of the state of the research field.

Methods: Randomised controlled trials investigating any aspect of breast reconstructions were included. The PubMed database was searched with a pre-defined search string. Inclusion and data abstraction was performed in a pre-defined standardised fashion. For the purpose of this study, we defined key issues as comparison of categories of breast reconstruction and comparison of immediate and delayed breast reconstruction, when the thematisation was done.

Results: A total of 419 abstracts were retrieved from the search. Of the 419, 310 were excluded as they were not RCTs concerning some aspect of breast reconstruction, which left us with 110 abstracts to be included in the study. The research questions of the included studies could more or less be divided into seven different themes inclusive of 2 key issues: Other issues - comparison of different categories of breast reconstruction, comparison of immediate and delayed breast reconstruction, surgical details within a category of breast reconstruction, surgical details valid for several categories of breast reconstruction, donor site management, anaesthetics, and non-surgical details. Only five studies compared key issues, and they all illustrate the challenges with RCTs in breast reconstruction.

Conclusions: A total of 110 publications based on RCTs in breast reconstruction have been published. Seven themes of research questions could be identified. Only five studies have explored the key issues. Better scientific evidence is needed for the key issues in breast reconstruction, for example by implementing a new study design in the field.

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乳房再造随机对照试验的系统回顾。

背景：对于乳房再造等偏好敏感的治疗方法，开展随机对照试验（RCT）存在障碍。本系统综述的主要目的是调查乳房再造随机对照试验探讨了哪些类型的研究问题，这些试验在哪些地方进行，在哪些地方发表，并将这些研究问题专题化，从而对该研究领域的现状进行概述：方法：纳入调查乳房重建任何方面的随机对照试验。使用预先定义的搜索字符串在 PubMed 数据库中进行搜索。按照预先确定的标准化方式进行纳入和数据摘录。为了本研究的目的，我们将关键问题定义为乳房重建类别的比较以及即刻和延迟乳房重建的比较：搜索共检索到 419 篇摘要。在这 419 篇摘要中，有 310 篇因不是涉及乳房再造某一方面的 RCT 而被排除，因此我们将 110 篇摘要纳入研究。纳入研究的研究问题大致可分为七个不同的主题，其中包括两个关键问题：其他问题--不同类别乳房再造的比较、即刻和延迟乳房再造的比较、一类乳房再造的手术细节、适用于几类乳房再造的手术细节、供体部位管理、麻醉和非手术细节。只有五项研究对关键问题进行了比较，这些研究都说明了乳房重建中的 RCT 所面临的挑战：共发表了 110 篇基于乳房重建 RCT 的论文。可以确定七个研究问题主题。只有五项研究探讨了关键问题。乳房再造的关键问题需要更好的科学证据，例如在该领域实施新的研究设计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Plastic Surgery and Hand Surgery ORTHOPEDICS-SURGERY

CiteScore

2.10

自引率

0.00%

发文量

108

审稿时长

6-12 weeks

期刊介绍： The purpose of the Journal of Plastic Surgery and Hand Surgery is to serve as an international forum for plastic surgery, hand surgery and related research. Interest is focused on original articles on basic research and clinical evaluation. The scope of the journal comprises: • Articles concerning operative methods and follow-up studies • Research articles on subjects related to plastic and hand surgery • Articles on cranio-maxillofacial surgery, including cleft lip and palate surgery. Extended issues are published occasionally, dealing with special topics such as microvascular surgery, craniofacial surgery, or burns. Supplements, usually doctoral theses, may also be published. The journal is published for the Acta Chirurgica Scandinavica society and sponsored by the Key Foundation, Sweden. The journal was previously published as Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.