Tactile Sensory Recovery in Neurotized Versus Non-Neurotized Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis

IF 1.7 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2025-07-18 DOI:10.1002/micr.70096

Alejandra Aristizábal, Harrison Herrera, Joseph M. Escandón, Pedro Ciudad, Gabriel del Corral, Rahim Nazerali, Andres Mascaro, Oscar J. Manrique

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引用次数: 0

Abstract

Background

Tactile sensory recovery in autologous breast reconstruction (ABR) has been shown to prevent injuries and improve quality of life. However, the studies comparing neurotized versus non-neurotized outcomes are still controversial due to methodological heterogeneity. This review uses consistent and objective outcomes to evaluate the current evidence's qualitative characteristics and quantitative tactile sensory recovery.

Methods

We conducted a systematic electronic literature search from database inception through 10 February 2024, of the following databases: PubMed, Ovid MEDLINE, Embase, SCOPUS, and CINAHL to identify all studies reporting outcomes of tactile sensory recovery using the Semmes-Weinstein Measuring scale in free-flap ABR comparing neurotization versus non-neurotization. The SWM scale score, demographic characteristics, and surgical features were extracted from each study. Due to the data heterogeneity within the studies, we transformed the data into means and pooled the qualitative information.

Results

We identified 264 articles. After thorough screening, 12 fulfilled the inclusion criteria and were included in the qualitative synthesis. Finally, 7 were quantitatively analyzed with a total of 251 breasts that underwent ABR with free flap neurotization and 244 breasts without neurotization. This revealed a mean SWM score difference of −0.67 and a significant p-value < 0.05. A subgroup DIEP flap analysis performed for 177 neurotized compared to 175 non-eurotized flaps yielded a significant mean difference of −0.86 p < 0.05. There were no significant differences between groups in age (48.8 vs. 49.8, p = 0.5), history of chemotherapy (72 vs. 74, p = 0.91), radiotherapy (61 vs. 56, p = 0.84), or follow-up time (21.85 vs. 25.09 months, p = < 0.05) that could have influenced tactile sensory recovery.

Conclusion

Neurotization in free-flap ABR could allow better tactile sensory recovery than the spontaneous sensation gained without it. The additional surgical time required for coaptation is short, and no studies have reported associated complications, making it a safe procedure that can potentially improve patients´ quality of life. Nonetheless, higher-quality studies, such as randomized control trials with standardized sensation testing and more rigorous methodologies, are needed before making final clinical recommendations.

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神经化与非神经化自体乳房重建的触觉恢复：系统回顾和荟萃分析

背景自体乳房再造术（ABR）中触觉感觉恢复已被证明可以预防损伤和提高生活质量。然而，由于方法的异质性，比较神经化与非神经化结果的研究仍然存在争议。本综述使用一致和客观的结果来评估当前证据的定性特征和定量触觉感觉恢复。方法从数据库建立到2024年2月10日，我们对以下数据库进行了系统的电子文献检索：PubMed、Ovid MEDLINE、Embase、SCOPUS和CINAHL，以确定所有使用Semmes-Weinstein自由皮瓣ABR测量量表比较神经化和非神经化的触觉感觉恢复结果的研究。从每项研究中提取SWM量表评分、人口统计学特征和手术特征。由于研究中数据的异质性，我们将数据转化为均值并汇集定性信息。结果共鉴定264篇。经彻底筛选，12例符合纳入标准，纳入定性综合。最后，定量分析了7个乳房，共251个乳房进行了ABR自由皮瓣神经化和244个乳房未神经化。结果显示，SWM平均评分差异为- 0.67，p值为0.05。对177个神经化皮瓣与175个非神经化皮瓣进行亚组DIEP分析，平均差异为- 0.86 p < 0.05。年龄（48.8个月对49.8个月，p = 0.5）、化疗史（72个月对74个月，p = 0.91）、放疗史（61个月对56个月，p = 0.84）、随访时间（21.85个月对25.09个月，p = < 0.05）对触觉感觉恢复的影响均无显著差异。结论游离皮瓣ABR的神经化治疗比不神经化治疗能更好地恢复触觉。适应所需的额外手术时间很短，并且没有相关并发症的研究报告，使其成为一种安全的手术，可以潜在地改善患者的生活质量。然而，在做出最终的临床建议之前，需要更高质量的研究，如标准化感觉测试的随机对照试验和更严格的方法。

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

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.