SynthesisFrontiers in oncology2025
A systematic review and meta-analysis on computed tomography angiography mapping for deep inferior epigastric perforator flap breast reconstruction.
Synthesis in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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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.
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.
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Who cites it
6 citing papers in PubMed.
- Influence of Preoperative Perforator Mapping Modality on Outcomes in DIEP Flap Breast Reconstruction: A Multicenter Registry Analysis.Journal of clinical medicine · 2026Article
- Technique-Driven and Patient-Specific Variations in Complications of Mastectomy with Immediate Breast Reconstruction: An Evidence-Based Review.Journal of clinical medicine · 2026Review
- Balancing Risk and Reconstruction: A Comprehensive Review of Complications in Delayed Breast Reconstruction.Journal of clinical medicine · 2026Review
- Artificial Intelligence in Breast Reconstruction: A Scoping Review of Pre-, Intra-, and Postoperative Applications.Plastic and reconstructive surgery. Global open · 2026Article
- Review
- Redefining Reconstruction: Technological Innovations in Microsurgical Breast Reconstruction.Cancers · 2025Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Breast cancer remains the most prevalent cancer among women globally, necessitating effective reconstructive options post-mastectomy. The deep inferior epigastric perforator (DIEP) flap is the gold standard for autologous breast reconstruction, though anatomical variability of perforators presents surgical challenges. Computed tomography angiography (CTA) has been proposed to enhance preoperative planning and reduce operative time. The aim of this study is to identify how CTA affects surgical outcomes in autologous breast reconstruction. Methods: A systematic review and meta-analysis (PROSPERO: CRD42024596646) were conducted per PRISMA guidelines. A comprehensive search of six databases identified studies comparing CTA with non-CTA imaging for DIEP flap reconstruction. Primary outcomes included operative time and flap loss rates. Risk of bias was assessed using ROBINS-I and RoB2, with quality appraised via AMSTAR-2 and GRADE. Results: Eighteen studies (3870 patients, 4283 flaps) were included. CTA guidance reduced unilateral flap operative time (mean 304.98 min vs. 390.18 min, CI -12.9 to 5.7; P = 0.2367), as well as partial and total flap loss rates (OR: 0.26, 95% CI: 0.14-0.47; OR: 0.30, 95% CI: 0.13-0.68). High heterogeneity (I² = 98.7%) limited generalizability. Prior reviews showed limitations in study design integrity, whereas this study achieved a high-confidence rating. Conclusions: Preoperative CTA improves surgical outcomes in DIEP flap reconstruction, though evidence quality is variable. Future research should compare CTA with MRA, assess cost-effectiveness, integrate AI-assisted imaging, and explore MRI-based protocols for optimized preoperative planning in microsurgical breast cancer reconstruction and enhanced oncologic care delivery. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024596646, idenitifier CRD42024596646.
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