Samargandi OA, et al. - This study aimed at assessing whether the thoracodorsal (Td) vessels have comparable clinical outcomes to the internal mammary (IM) vessels as recipients for autologous free tissue transfer for breast reconstruction. In this study, both recipient vessels proved safe, reliable and demonstrated equivocal results in the absence of contraindications. Utilizing either as a first-line vessel seemed reasonable, depending on surgeons' preference or certain clinical scenarios.

Methods

• Two independent reviewers peformed systematic searches of MEDLINE, EMBASE, CENTRAL, and World of Science from inception to June 2016.
• They selected studies that included adult females undergoing autologous free tissue transfer for breast reconstruction.
• For this study, the two comparison groups were the use of IM or Td as recipient vessels.
• Rate of flap survival was assessed primarily.
• The methodologic quality of included studies was assessed using the JADAD and MINOR scales.

Results

• The 10 articles included in this analysis yielded 1897 patients that underwent 2644 free abdominal flap tissue transfer.
• There was one randomized controlled study (Jadad score 2/5) and 9 nonrandomized controlled studies (MINORS scores 11–19/24).
• No difference between the uses of either vessel in terms of flap loss was identified(1.18; 95% CI 0.71–1.95).
• Among the IM vessels, complication rate ranged from 5 to 12%, compared with 3.4–12% among Td vessels.
• There appeared variation regarding hematoma and seroma rates.
• Two studies suggested higher fat necrosis with Td vessels.
• Performing Td vessels anastomosis seemed associated with shorter operative time and greater risk of encountering unusable vessel.