Benefit of the Omental Flap in Breast Reconstruction for Oncoplastic Treatment: A Systematic Review and Single-Arm Meta-Analysis

Oncoplastic surgery for breast cancer patients poses the challenge of achieving optimal aesthetic outcomes without increasing the risk of complications. Omental flap has emerged as n reconstructive option in breast surgery, yet the efficacy and safety of large omental flaps remain uncertain. This study aims to conduct a systematic review and single-arm meta-analysis to comprehensively evaluate the effectiveness, safety, and cosmetic outcomes of large omental flap breast reconstruction, providing updated evidence for clinical practice.

We systematically searched Embase, PubMed, Cochrane Library, and CNKI databases until August 2023. Studies were screened using inclusion and exclusion criteria. The quality of each study was evaluated with the Newcastle-Ottawa Scale. Meta-analysis was performed using R version 4.2.0.

A total of 22 studies with 1031 patients were reviewed and analyzed. Meta-analysis results showed that hematoma and seroma rate were 4.1% (95%CI 0.8-8.8, P < 0.01). The pooled cosmetic outcomes demonstrated excellent rate 56.7% (95%CI 46.4-69.3, P < 0.01), good rate 7.9% (95%CI 3.9-11.9, P < 0.01), fair rate 28.7% (95%CI 19.9-37.5, P < 0.01). The pooled blood loss was 110.74 ml (95%CI: 72.33-149.14, P = 0), hospital stays was 7.27 (95%CI 5.65-8.89, P < 0.01), the time of omental flap harvest was 65.63 min (95%CI 59.95-71.32, P < 0.01), the time for surgery was 240.87 min (95%CI 5.65- 8.89, P = 0).

This meta-analysis indicates that the omental flap in breast reconstruction is safe and effective with good cosmetic outcomes and a low incidence of complications. The study highlights the benefits of comprehensive assessment, warranting further investigation through high-quality studies and long-term follow-up.

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