目的:综合评价股前外侧皮瓣在下肢重建(LLR)手术中的临床疗效,并通过Meta分析探讨其应用价值。
方法:在PubMed等英文数据库中检索了有关LLR股前外侧皮瓣功效的发表的文章,WebofScience,Embase,和Cochrane图书馆,从成立之初到2023年11月进行了搜索。搜索词包括“大腿前外侧皮瓣”,“下肢”,“自由肌肉”和“重建”。随后,对符合条件的研究进行了数据提取,采用RevMan5.3软件进行数据分析。
结果:最终选择包括12项适当的研究,共包括577名患者。Meta分析显示,不同类型皮瓣患者的住院时间差异可忽略不计(均差(MD)=-0.10,95%置信区间(CI)=-0.400.20,P>0.05)。此外,并发症的发生率差异不大(Riskdifference,RD=-0.02,95%CI=-0.090.05,P>0.05)。二次手术的发生率也没有显着差异(RD=-0.04,95%CI=-0.11-0.04,P>0.05)。然而,接受股前外侧皮瓣移植的患者的供体部位发病率急剧下降(赔率比(OR)=0.22,95%CI=0.10-0.49,P<0.05)。
结论:股前外侧皮瓣在LLR手术中的临床疗效与住院时间无明显差异。并发症发生率,或需要二次手术相比其他皮瓣。然而,在LLR中使用股前外侧皮瓣可显着降低供体部位的发病率。
OBJECTIVE: To comprehensively assess the clinical efficacy of the anterolateral thigh flap in lower limb reconstruction (LLR) surgeries and explore its application value via a meta-analysis.
METHODS: Published articles on the efficacy of anterolateral thigh flap in LLR were retrieved in English databases such as PubMed, Web of Science, Embase, and The Cochrane Library, which were searched from their inception to November 2023. The search terms included \"anterolateral thigh flaps\", \"lower extremity\", \"free muscle\" and \"reconstruction\". Subsequently, data extraction of eligible studies was carried out, and data analysis was conducted using RevMan 5.3 software.
RESULTS: The final selection comprised 12 appropriate studies, encompassing a total of 577 patients. Meta-analysis demonstrated that negligible differences existed in the length of hospital stay among patients treated with different types of flaps (mean difference (MD) =-0.10, 95% confidence interval (CI) =-0.400.20, P>0.05). Additionally, the occurrence of complications differed slightly (Risk difference (RD) =-0.02, 95% CI=-0.090.05, P>0.05). The incidence of secondary surgeries also demonstrated non-significant differences (RD=-0.04, 95% CI=-0.11-0.04, P>0.05). Nevertheless, patients who underwent anterolateral thigh flap transplantation exhibited a drastic decrease in donor site morbidity (Odds ratio (OR) =0.22, 95% CI=0.10-0.49, P<0.05).
CONCLUSIONS: The clinical efficacy of the anterolateral thigh flap in LLR surgeries shows no significant differences in hospital stay, complication rates, or the need for secondary surgeries compared to other flaps. However, using anterolateral thigh flap in LLR significantly reduces donor site morbidity.