Evidence map›Paper›PMID 38927919›Full record

ReviewCancers2024

Perforator versus Non-Perforator Flap-Based Vulvoperineal Reconstruction-A Systematic Review and Meta-Analysis.

Séverin Wendelspiess, Loraine Kouba, Julia Stoffel, Nicole Speck, Christian Appenzeller-Herzog, Brigitta Gahl, Céline Montavon, Viola Heinzelmann-Schwarz, Ana Lariu, Dirk J Schaefer and 2 more

Abstract readReview
In one paragraph

Review in Cancers, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Séverin WendelspiessDepartment of Medicine, University of Basel, 4056 Basel, Switzerland.
Loraine KoubaDepartment of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Julia StoffelDepartment of Medicine, University of Basel, 4056 Basel, Switzerland.
Nicole SpeckDepartment of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, 4031 Basel, Switzerland.ORCID 0000-0003-2039-4230
Christian Appenzeller-HerzogDepartment of Medicine, University of Basel, 4056 Basel, Switzerland.ORCID 0000-0001-7430-294X
Brigitta GahlSurgical Outcome Research Center, University Hospital Basel, 4031 Basel, Switzerland.ORCID 0000-0001-8123-0438
Céline MontavonDepartment of Gynecology and Gynecological Oncology, University Hospital Basel, 4031 Basel, Switzerland.ORCID 0000-0002-4186-445X
Viola Heinzelmann-SchwarzDepartment of Gynecology and Gynecological Oncology, University Hospital Basel, 4031 Basel, Switzerland.
Ana LariuDepartment of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Dirk J SchaeferDepartment of Medicine, University of Basel, 4056 Basel, Switzerland.
Tarek IsmailDepartment of Medicine, University of Basel, 4056 Basel, Switzerland.
Elisabeth A KapposDepartment of Medicine, University of Basel, 4056 Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with advanced vulvoperineal cancer require a multidisciplinary treatment approach to ensure oncological safety, timely recovery, and the highest possible quality of life (QoL). Reconstructions in this region often lead to complications, affecting approximately 30% of patients. Flap design has evolved towards perforator-based approaches to reduce functional deficits and (donor site) complications, since they allow for the preservation of relevant anatomical structures. Next to their greater surgical challenge in elevation, their superiority over non-perforator-based approaches is still debated.

methodsTo compare outcomes between perforator and non-perforator flaps in female vulvoperineal reconstruction, we conducted a systematic review of English-language studies published after 1980, including randomized controlled trials, cohort studies, and case series. Data on demographics and surgical outcomes were extracted and classified using the Clavien-Dindo classification. We used a random-effects meta-analysis to derive a pooled estimate of complication frequency (%) in patients who received at least one perforator flap and in patients who received non-perforator flaps.

resultsAmong 2576 screened studies, 49 met our inclusion criteria, encompassing 1840 patients. The overall short-term surgical complication rate was comparable in patients receiving a perforator (

conclusionsVulvoperineal reconstruction using perforator flaps shows promising results compared with non-perforator flaps. There is a need for the assessment of its long-term outcomes and for a systematic evaluation of patient QoL to further demonstrate its benefit for affected patients.

Indexed as

cancercomplicationsfemalenon-perforator flapperforator flapquality of lifereconstructionsurgical outcomesvulvoperineal

Identifiers

PMID38927919
PMCPMC11202299

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.