AB055. SOH25_AB_334. The effect of sarcopenia on postoperative complications in autologous breast reconstruction—a systematic review and meta-analysis
General Surgery I

AB055. SOH25_AB_334. The effect of sarcopenia on postoperative complications in autologous breast reconstruction—a systematic review and meta-analysis

Cian Hehir1,2, Gavin Dowling1, Gavin Calpin1,2, Barry O’Sullivan2, Nadeem Ajmal2, James Martin-Smith2, Roisin Dolan2

1Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland

Background: Sarcopenia refers to loss of muscle mass combined with associated loss in muscle function and has been demonstrated to predict postoperative complications across a range of surgical procedures. The effect of sarcopenia on outcomes in autologous breast reconstruction remains uncertain. This systematic review and meta-analysis aims to further evaluate this relationship in the context of autologous breast reconstruction.

Methods: A systematic review of electronic databases was performed in conjunction with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting on postoperative complications in sarcopenic versus non-sarcopenic patients undergoing autologous breast reconstruction were included. Sarcopenia was identified by directly measuring psoas muscle cross-sectional area (PMA) on computed tomography (CT) scan. Meta-analysis was carried out on any complication reported in three or more journal articles.

Results: Six studies were included in meta-analysis. Non-sarcopenic patients were found to be at a significantly increased risk of haematoma formation [odds ratio (OR) =1.84, 95% confidence interval (CI): 1.06–3.18, P=0.03], but this was not associated with an increased risk of return to theatre due to haematoma (OR =1.11, 95% CI: 0.36–3.38, P=0.86). There was no statistically significant difference in risk of total flap loss, partial flap loss, flap infection, flap seroma formation, donor site complications, risk of reoperation nor wound dehiscence between sarcopenic and non-sarcopenic cohorts.

Conclusions: This study reports that sarcopenia does not predispose patients to increased risk of postoperative complications in the context of autologous breast reconstruction. This may indicate a lack of supporting evidence for the inclusion of prehabilitation in delayed breast reconstruction. Further prospective studies reporting on body mass index (BMI), PMA and psoas muscle density are required.

Keywords: Breast reconstruction; sarcopenia; complications; free flap; meta-analysis

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab055
Cite this abstract as: Hehir C, Dowling G, Calpin G, O’Sullivan B, Ajmal N, Martin-Smith J, Dolan R. AB055. SOH25_AB_334. The effect of sarcopenia on postoperative complications in autologous breast reconstruction—a systematic review and meta-analysis. Mesentery Peritoneum 2025;9:AB055.

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