Résumé
Objective To analyze the complications of breast reconstruction with pedicled transverse rectus abdominis myocutaneous flap (TRAM flap) and latissimus dorsi flap (LDF).Methods From databases such as CNKI,SinoMed,PubMed,VIP and Cochrane Library and manual search of articles on breast reconstruction with pedicled TRAM and LDF from 1992 to 2002 for the language of both Chinese and English,1493 cases were collected.47 cases were selected after they all were inspected by the excluded and included standards.RevMan 5.0 software was used to perform the Mantele-Haenszel fixed effect model.Results Ten studies reporting outcomes of pedicled TRAM and LDF were used to estimate relative risk (RR) and 95 ％ confidence interval (CI) for complications.There was a 1.7 times increase in the risk of partial flap necrosis (relative risk,1.72; 95 ％ CI,1.02to 2.88) in pedicled TRAM flap patients compared with LDF patients.There was no difference in the risk for fat necrosis (relative risk,1.01; 95 ％ CI,0.60 to 1.72) and total flap loss (relative risk,2.13; 95 ％ CI,0.82 to 5.54) between pedicled TRAM flap and LDF patients (P＞0.05).Conclusions Compared with the pedicled TRAM flap,partial flap loss risk of breast reconstruction with LDF is lower,and the risk of fat necrosis and total flap loss have no statistical difference (P＞0.05).