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Protocol for a Systematic Review and Meta-analysis on the Clinical Outcomes and Cost of Deep Inferior Epigastric Perforator (Diep) Flap Versus Implants for Breast Reconstruction

Khajuria, A; Smith, OJ; Prokopenko, M; Greenfield, M; Mosahebi, A; (2017) Protocol for a Systematic Review and Meta-analysis on the Clinical Outcomes and Cost of Deep Inferior Epigastric Perforator (Diep) Flap Versus Implants for Breast Reconstruction. Systematic Reviews , 6 (232) 10.1186/s13643-017-0628-y. Green open access

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Abstract

BACKGROUND: Mastectomy in the context of breast malignancy can have a profoundly negative impact on a woman’s self-image, impairing personal, sexual and social relationships. The deep inferior epigastric perforator (DIEP) flap and implants are the two commonest reconstructive modalities that can potentially overcome this psychological trauma. The comparative data on clinical outcomes and costs of the two modalities is limited. We aim to synthesise the current evidence on DIEP versus implants to establish which is the superior technique for breast reconstruction, in terms of clinical outcomes and cost-effectiveness. METHODS A comprehensive search will be undertaken of EMBASE, MEDLINE, Google Scholar, CENTRAL and Science citation index databases (1994 up to August 2017) to identify studies relevant for the review. Primary human studies evaluating clinical outcomes and cost of DIEP and implant-based reconstruction in context of breast malignancy will be included. Primary outcomes will be patient satisfaction and cosmetic outcome from patient-reported outcome measures (scores from validated tools, e.g. BREAST-Q tool), complications and cost-analysis. The secondary outcomes will be duration of surgery, number of surgical revisions, length of stay, availability of procedures and total number of clinic visits. DISCUSSION: This will be the first systematic review and meta-analysis in available literature comparing the clinical outcomes and cost-effectiveness of DIEP and implants for breast reconstruction. This review is expected to guide worldwide clinical practice for breast reconstruction.

Type: Article
Title: Protocol for a Systematic Review and Meta-analysis on the Clinical Outcomes and Cost of Deep Inferior Epigastric Perforator (Diep) Flap Versus Implants for Breast Reconstruction
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s13643-017-0628-y
Publisher version: https://doi.org/10.1186/s13643-017-0628-y
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Breast implant, DIEP, Cost-effectiveness, Autologous flap, reconstruction, Deep inferior epigastric artery perforator flap
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10058715
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