Optimal Recipient Nerve Selection for Breast Neurotization with Abdominal Flaps: A Comprehensive Meta-Analysis of Anterior and Lateral Intercostal Approaches

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background: Breast reconstruction post-mastectomy has increasingly emphasized the importance of sensory restoration. This study aimed to evaluate the comparative efficacy of anterior versus lateral cutaneous intercostal nerve branches in neurotization during abdominal-based autologous breast reconstruction. Methods: Through a systematic literature search and meta-analysis, we reviewed studies published between January 2003 and August 2023. Our methods involved categorizing studies based on the nerve branch used, extracting relevant data, and conducting a quality assessment. To determine the difference in the magnitude of sensory recovery, a meta-analysis was conducted to pool the effect sizes (mean differences) from individual studies. Given the potential for heterogeneity across studies, a random-effects model was employed using the DerSimonian and Laird method. Subgroup analysis was then performed to separately evaluate the effect sizes for the anterior and lateral groups. Results: We identified five studies for the anterior group and five studies for the lateral group. The anterior group included a total of 225 non-neurotized and 240 neurotized breasts, while the lateral group consisted of 62 non-neurotized and 51 neurotized breasts. The anterior group exhibited superior sensory recovery compared to the lateral group ( p = 0.08 for the common effect model). The result was bo

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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