Value Added Abstracts
Edgard da Silva
Abstract
Background: Laser assisted Indocyanine Green Angiography (LAICGA) has actually become a reality, helping surgeons to determine flap perfusion intraoperative and allowing best outcomes in breast reconstruction, by determining flap viability and secure volume of intraoperative expansion. This study stratified outcomes based on a meta-analysis of complications. Objective: A systematic review and meta-analysis to verify if LAICGA prevents complications and improve outcomes in breast reconstruction Methods: Only longitudinal trials comparing clinical assessment of skin flaps to pacients submitted to LAICGA during breast reconstruction trials were included. MEDLINE (PubMed), Google Scholar and LILACS databases were searched for articles published up to December 2018. Random-effects meta-analyses were conducted for complications (necrosis, infection, seroma and surgical reintervention. Results: Ten studies reporting LAICGA in breast reconstructions met inclusion criteria containing control group with clinical evaluation and reported outcomes of interest (n: 2256). The risk of ocurrence of flap necrosis was 2.06 times higher in control group (clinical assessment), with statistical relevance (p: 0.0006), 95% CI (1.36 – 3.11). Necessity of reoperation for any complication was statistically relevant, addind a relative risk of 2.06 comparing to clinical assessment (p:0.0002), 95% CI (1.41-3.0). Incidence of infection was higher on the control group (OR: 1.78, 95% CI,1.00 – 3.17) but not statistically relevant (p: 0.05). Seroma did not differ from both groups neither clinically or statistically (OR: 1.06, 95% CI, 0.60-1.86, p: 0,85). Conclusions: The use of LAICGA during breast reconstruction procedures prevents form necrotic events and need for surgical reintervention. The study suggests that LAICGA has benefits from preventing infection.