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自体脂肪移植在乳腺癌手术中的止痛效果:一项范围综述

Pain-relieving Effects of Autologous Fat Grafting in Breast Cancer Surgery: A Scoping Review.

作者信息

Sowa Yoshihiro, Nakayama Ichiro, Toyohara Yoshihiro, Higai Shino, Yoshimura Kotaro

机构信息

From the Department of Plastic Surgery, Jichi Medical University, Shimotsuke City, Japan.

Department of Breast Surgery, Kyoto Miniren Chuo Hospital, Kyoto, Japan.

出版信息

Plast Reconstr Surg Glob Open. 2024 Jun 14;12(6):e5909. doi: 10.1097/GOX.0000000000005909. eCollection 2024 Jun.

Abstract

BACKGROUND

Chronic pain is relatively common after breast cancer surgery, including breast reconstruction. Autologous fat grafting (AFG) has gained attention as a novel method for breast reconstruction, and recent clinical studies have also shown effects of AFG on alleviation of chronic pain after breast cancer surgery. Our objective was to conduct a scoping review of studies that have examined these effects with clearly defined clinical outcomes.

METHODS

A literature search was conducted using three databases: PubMed, MEDLINE, and Google Scholar, following PRISMA guidelines and the Arkesy and O'Malley framework. The search focused on clinical studies of the effects of AFG on chronic pain after breast cancer surgery. All studies reporting functional outcomes, return to work, and secondary surgery in a repeat operation were identified.

RESULTS

Of the 148 studies identified in the search, 11 studies with a total of 684 patients were included in the review. The average volume of fat grafted was approximately 128 mL over an average of 1.6 sessions. The most common time point for assessment was 1 year post-AFG. In all studies with an evidence level of 3 or lower, AFG showed positive results in alleviating pain after breast cancer surgery. However, one of the three randomized controlled trials did not show clinically significant effects.

CONCLUSIONS

Most of the studies examined in this review suggested pain-relieving effects of AFG. However, there was one randomized controlled trial in which these effects were not confirmed, indicating a need for further accumulation of cases and performance of new, well-designed randomized controlled trials.

摘要

背景

慢性疼痛在乳腺癌手术后相对常见,包括乳房重建术后。自体脂肪移植(AFG)作为一种乳房重建的新方法受到关注,最近的临床研究也表明AFG对缓解乳腺癌手术后的慢性疼痛有效果。我们的目的是对已通过明确界定的临床结局来研究这些效果的研究进行一项范围综述。

方法

按照PRISMA指南以及阿基西和奥马利框架,使用三个数据库进行文献检索:PubMed、MEDLINE和谷歌学术。检索重点是AFG对乳腺癌手术后慢性疼痛影响的临床研究。确定了所有报告功能结局、恢复工作情况以及再次手术中的二次手术情况的研究。

结果

在检索中确定的148项研究中,有11项研究共684例患者被纳入综述。平均脂肪移植量约为128毫升,平均进行1.6次移植。最常见的评估时间点是AFG后1年。在所有证据水平为3级或更低的研究中,AFG在缓解乳腺癌手术后疼痛方面显示出积极结果。然而,三项随机对照试验中的一项未显示出临床显著效果。

结论

本综述中审查的大多数研究表明AFG有止痛效果。然而,有一项随机对照试验未证实这些效果,这表明需要进一步积累病例并开展新的、设计良好的随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ab8/11177809/a54810581341/gox-12-e5909-g001.jpg

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