Complications of Immediate Versus Delayed DIEP Reconstruction: A Meta-Analysis of Comparative Studies

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2022 Sep 9

PMID 36077807

Authors

Andre S Alves

Vincent Tan

Matteo Scampa

Daniel F Kalbermatten

Carlo M Oranges

Affiliations

Soon will be listed here.

Abstract

Purpose: The setting regarding the ideal timing for deep inferior epigastric perforator flap (DIEP) reconstruction remains unclear. Immediate breast reconstruction (IBR) is performed at the same time as mastectomy, while delayed breast reconstruction (DBR) is performed at any time after mastectomy except immediately. We compared both strategies to assess whether IBR or DBR should be performed to reduce postoperative adverse events.

Methods: A systematic review of PubMed, Embase, Medline, Cochrane, and Web of Science was conducted, aiming at articles comparing the recipient site outcomes of IBR versus DBR with DIEP. We used the Mantel-Haenszel method with a fixed effects model. Results were expressed as the OR with a 95% CI.

Results: Two retrospective and two prospective studies were identified involving 5784 DIEPs (1744 immediate and 4040 delayed). We showed a significant difference in favor of IBR for wound healing issues (OR = 0.57, 95% CI 0.41, 0.77; = 0.0003). However, no significant differences for hematoma, infection, fat necrosis, partial flap loss, and total flap loss rate were seen.

Conclusions: Despite variability in the choice of the ideal time for breast reconstruction and outcomes reported among studies, immediate DIEP surgery appears to be a reliable setting with less delayed healing issues.

Citing Articles

Analysis of Postoperative Outcomes in Unilateral Versus Bilateral DIEP Flap Reconstructions: A Single-Center Retrospective Study.

Tekdogan B, Martineau J, Verbat M, Dong E, Correia D, Oranges C J Clin Med. 2025; 14(4).

PMID: 40004590 PMC: 11856815. DOI: 10.3390/jcm14041056.

Outcomes and Current State of Deep Inferior Epigastric Perforator Flap Surgery in Peru and Mexico.

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The Impact of Preoperative Radiotherapy and Chemotherapy on Autologous Breast Reconstruction Outcomes-A Retrospective Single-Center Study.

Nava C, Martineau J, Dong E, Zinner G, Oranges C Cancers (Basel). 2025; 17(3).

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A Meta-analysis Comparing Deep Inferior Epigastric Perforator Flaps and Latissimus Dorsi Flaps in Breast Reconstruction.

Tanas Y, Tanas J, Swed S, Spiegel A Plast Reconstr Surg Glob Open. 2024; 12(10):e6206.

PMID: 39386099 PMC: 11463201. DOI: 10.1097/GOX.0000000000006206.

Unveiling Intricacies of DIEP Breast Reconstruction Post Early Breast Cancer: A Deep Dive into a Case of Unforeseen Complications.

Xie L, Kong X, Gao J Cancer Manag Res. 2024; 16:337-345.

PMID: 38650978 PMC: 11034507. DOI: 10.2147/CMAR.S429782.

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