A Systematic Review and Meta-analysis Comparing Inferior Pedicle and Superomedial Pedicle Techniques in Reduction Mammaplasty for Gigantomastia: Postoperative Complications, Aesthetic Outcomes and Quality of Life.
TL;DR
Trends favored the superomedial pedicle in most metrics, including overall complication rate, NAC necrosis and NAC sensitivity, while the inferior pedicle may offer certain advantages in specific outcomes, but current comparative evidence remains limited.
OpenAlex 토픽 ·
Breast Implant and Reconstruction
Reconstructive Surgery and Microvascular Techniques
Breast Cancer Treatment Studies
Abstract
[BACKGROUND] Macromastia, particularly in its severe form-gigantomastia-is characterized by excessive mammary tissue growth and significantly impairs quality of life through physical symptoms, psychological distress and functional limitations. Reduction mammaplasty remains the standard of care, aiming to relieve symptoms while preserving breast function and aesthetics. Several surgical techniques based on vascular pedicles have been developed, including the superomedial and inferior pedicle approaches. However, few studies have compared these techniques in patients requiring large-volume resections.
[METHODS] We conducted a systematic review and meta-analysis comparing the inferior and superomedial pedicle techniques in patients with gigantomastia, defined as a resection volume ≥ 800 grams per breast. Multiple databases were searched for studies published from 2010 onward. Statistical analyses were performed using Review Manager 5.4.1, applying a random-effects model. Primary outcomes included postoperative complications, aesthetic results, and quality of life indicators. Ninety-five percent confidence intervals were calculated using the Mantel-Haenszel method. Heterogeneity was assessed using the I statistic, and risk of bias in non-randomized studies was evaluated with the Newcastle-Ottawa Scale.
[RESULTS] Eight comparative studies were included. No statistically significant differences were found in the primary outcomes. However, trends favored the superomedial pedicle in most metrics, including overall complication rate, NAC necrosis and NAC sensitivity.
[CONCLUSIONS] Both techniques appear to be safe and effective options for patients with severe macromastia. The superomedial pedicle may offer certain advantages in specific outcomes, but current comparative evidence remains limited. Further randomized controlled trials are needed to better inform surgical decision-making in this population.
[LEVEL OF EVIDENCE III] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
[METHODS] We conducted a systematic review and meta-analysis comparing the inferior and superomedial pedicle techniques in patients with gigantomastia, defined as a resection volume ≥ 800 grams per breast. Multiple databases were searched for studies published from 2010 onward. Statistical analyses were performed using Review Manager 5.4.1, applying a random-effects model. Primary outcomes included postoperative complications, aesthetic results, and quality of life indicators. Ninety-five percent confidence intervals were calculated using the Mantel-Haenszel method. Heterogeneity was assessed using the I statistic, and risk of bias in non-randomized studies was evaluated with the Newcastle-Ottawa Scale.
[RESULTS] Eight comparative studies were included. No statistically significant differences were found in the primary outcomes. However, trends favored the superomedial pedicle in most metrics, including overall complication rate, NAC necrosis and NAC sensitivity.
[CONCLUSIONS] Both techniques appear to be safe and effective options for patients with severe macromastia. The superomedial pedicle may offer certain advantages in specific outcomes, but current comparative evidence remains limited. Further randomized controlled trials are needed to better inform surgical decision-making in this population.
[LEVEL OF EVIDENCE III] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | mammaplasty
|
유방성형술 | dict | 2 | |
| 해부 | breast
|
유방 | dict | 2 | |
| 해부 | nac
|
유방 | dict | 2 | |
| 해부 | mammary
|
유방 | dict | 1 | |
| 해부 | Superomedial Pedicle Techniques
|
scispacy | 1 | ||
| 해부 | mammary tissue
|
scispacy | 1 | ||
| 해부 | superomedial
|
scispacy | 1 | ||
| 합병증 | necrosis
|
괴사 | dict | 1 | |
| 약물 | NAC necrosis
|
scispacy | 1 | ||
| 질환 | Macromastia
|
C0020565
Hypertrophy of Breast
|
scispacy | 1 | |
| 질환 | gigantomastia
|
C0020565
Hypertrophy of Breast
|
scispacy | 1 | |
| 질환 | postoperative complications
|
C0032787
Postoperative Complications
|
scispacy | 1 | |
| 기타 | vascular pedicles
|
scispacy | 1 | ||
| 기타 | superomedial pedicle
|
scispacy | 1 |
MeSH Terms
Humans; Mammaplasty; Quality of Life; Hypertrophy; Breast; Esthetics; Female; Treatment Outcome; Postoperative Complications; Surgical Flaps; Risk Assessment; Adult
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