Comparison of Donor Site Morbidity Between Anterolateral Thigh and Radial Forearm Free Flaps for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis

作者全名："Niu, Zehao; Chen, Youbai; Li, Yan; Tao, Ran; Lei, Yonghong; Guo, Lingli; Zhang, Fugui; Zhang, Haizhong; Zhang, Qixu; August, Meredith; Han, Yan"

作者地址："[Niu, Zehao; Chen, Youbai; Li, Yan; Tao, Ran; Lei, Yonghong; Guo, Lingli; Han, Yan] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Plast & Reconstruct Surg, 28 Fuxing St, Beijing 100853, Peoples R China; [Zhang, Fugui] Chongqing Med Univ, Dept Oral & Maxillofacial Surg, Stomatol Hosp, Chongqing, Peoples R China; [Zhang, Haizhong] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Oral & Maxillofacial Surg, Beijing, Peoples R China; [Zhang, Qixu] Univ Texas MD Anderson Canc Ctr, Dept Plast Surg, Houston, TX USA; [August, Meredith] Harvard Sch Dent Med, Boston, MA USA"

通信作者："Han, Y (corresponding author), Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Plast & Reconstruct Surg, 28 Fuxing St, Beijing 100853, Peoples R China."

来源：JOURNAL OF CRANIOFACIAL SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000671116400064

JCR分区：Q3

影响因子：0.9

年份：2021

卷号：32

期号：5

开始页：1706

结束页：1711

文献类型：Review

关键词：Anterolateral thigh free flap; donor site morbidity; microvascular surgery; radial forearm free flap; reconstruction

摘要："This meta-analysis aimed to provide an up-to-date comparison of donor site morbidity (DSM) between patients who underwent head and neck reconstruction with Anterolateral thigh (ALT) and radial forearm free (RFF) flaps. We searched the PubMed, Web of Science, EMBASE, and Cochrane Library databases to identify studies that compared DSM between ALT and RFF patients. Study quality was assessed using the Newcastle-Ottawa Scale. The pooled odds ratio (OR) of each DSM between ALT and RFF patients was estimated using a random- or fixed-effect model depending on the degree of interstudy heterogeneity. Sensitivity and subgroup analyses were performed if substantial heterogeneity was detected. Eighteen cohort studies with 1,018 patients (535 ALT and 483 RFF patients) were included. Compared with RFF, ALT were associated with lower risks of wound dehiscence (OR = 0.2, 95%CI: 0.10-0.42, P < 0.01), strength impairment (OR = 0.18, 95%CI: 0.07-0.47, P < 0.01), and movement impairment (OR = 0.19, 95%CI:0.07-0.49, P < 0.01). A subgroup analysis showed that ALT were associated with a lower risk of donor site numbness among patients undergoing tongue reconstruction (OR = 0.05, 95%CI: 0.01-0.25, P < 0.01), but not among all patients undergoing head and neck reconstruction. The pooled ORs of other DSMs demonstrated no significant difference between ALT and RFF patients. ALT are superior to RFF for head and neck reconstruction in terms of donor site wound dehiscence, strength impairment, movement impairment, and for tongue reconstruction specifically in terms of donor site numbness. No significant differences in the incidence of donor site hematoma/seroma, infection, or dissatisfaction with donor site appearance were identified between ALT and RFF patients."

基金机构：　

基金资助正文：