Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.

<h4>Objective</h4>An evidence regarding which bony flap for reconstruction of mandibular defects following tumour resection is associated with the highest survival rate is still lacking. This network meta-analysis (NMA) aimed to guide surgeons selecting which vascularized osseous flap is...

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Autores principales:	Mubarak Ahmed Mashrah, Taghrid Aldhohrah, Ahmed Abdelrehem, Karim Ahmed Sakran, Hyat Ahmad, Hamada Mahran, Faisal Abu-Lohom, Hanfu Su, Ying Fang, Liping Wang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7697ccdb8bad4a719e09356650b383d7
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spelling	oai:doaj.org-article:7697ccdb8bad4a719e09356650b383d72021-12-02T20:16:37ZSurvival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.1932-620310.1371/journal.pone.0257457https://doaj.org/article/7697ccdb8bad4a719e09356650b383d72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257457https://doaj.org/toc/1932-6203<h4>Objective</h4>An evidence regarding which bony flap for reconstruction of mandibular defects following tumour resection is associated with the highest survival rate is still lacking. This network meta-analysis (NMA) aimed to guide surgeons selecting which vascularized osseous flap is associated with the highest survival rate for mandibular reconstruction.<h4>Methods</h4>From inception to March 2021, PubMed, Embase, Scopus, and Cochrane library were searched to identify the eligible studies. The outcome variable was the flap survival rate. The Bayesian NMA accompanied by a random effect model and 95% credible intervals (CrI) was calculated.<h4>Results</h4>Twenty-two studies with a total of 1513 patients, comparing four osseous flaps namely fibula free flap (FFF), deep circumferential iliac artery flap (DCIA), scapula flap, and osteocutaneous radial forearm flap (ORFF) were included. The respective survival rates of FFF, DCIA, Scapula, and ORFF were 94.50%, 93.12%, 97%, and 95.95%. The NMA failed to show a statistically significant difference between all comparators (FFF versus DCIA (Odd ratio, 1.8; CrI, 0.58,5.0); FFF versus ORFF (Odd ratio, 0.57; CrI, 0.077; 2.9); FFF versus scapula flap (Odd ratio, 0.25; CrI, 0.026; 1.5); DCIA versus ORFF (Odd ratio, 0.32; CrI, 0.037; 2.1); DCIA versus scapula flap (Odd ratio, 0.14; CrI, 0.015; 1.1) and ORFF versus scapula flap (Odd ratio, 2.3; CrI, 0.16; 34)).<h4>Conclusion</h4>Within the limitations of the current NMA, FFF, DCIA, Scapula, and ORFF showed a comparable survival rate for mandibular reconstruction. Although the scapula flap reported the highest survival rate compared to other osseous flaps for mandibular reconstruction; however, the decision making when choosing an osseous flap should be based on many factors rather than simply flap survival rate.Mubarak Ahmed MashrahTaghrid AldhohrahAhmed AbdelrehemKarim Ahmed SakranHyat AhmadHamada MahranFaisal Abu-LohomHanfu SuYing FangLiping WangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0257457 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mubarak Ahmed Mashrah Taghrid Aldhohrah Ahmed Abdelrehem Karim Ahmed Sakran Hyat Ahmad Hamada Mahran Faisal Abu-Lohom Hanfu Su Ying Fang Liping Wang Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.
description	<h4>Objective</h4>An evidence regarding which bony flap for reconstruction of mandibular defects following tumour resection is associated with the highest survival rate is still lacking. This network meta-analysis (NMA) aimed to guide surgeons selecting which vascularized osseous flap is associated with the highest survival rate for mandibular reconstruction.<h4>Methods</h4>From inception to March 2021, PubMed, Embase, Scopus, and Cochrane library were searched to identify the eligible studies. The outcome variable was the flap survival rate. The Bayesian NMA accompanied by a random effect model and 95% credible intervals (CrI) was calculated.<h4>Results</h4>Twenty-two studies with a total of 1513 patients, comparing four osseous flaps namely fibula free flap (FFF), deep circumferential iliac artery flap (DCIA), scapula flap, and osteocutaneous radial forearm flap (ORFF) were included. The respective survival rates of FFF, DCIA, Scapula, and ORFF were 94.50%, 93.12%, 97%, and 95.95%. The NMA failed to show a statistically significant difference between all comparators (FFF versus DCIA (Odd ratio, 1.8; CrI, 0.58,5.0); FFF versus ORFF (Odd ratio, 0.57; CrI, 0.077; 2.9); FFF versus scapula flap (Odd ratio, 0.25; CrI, 0.026; 1.5); DCIA versus ORFF (Odd ratio, 0.32; CrI, 0.037; 2.1); DCIA versus scapula flap (Odd ratio, 0.14; CrI, 0.015; 1.1) and ORFF versus scapula flap (Odd ratio, 2.3; CrI, 0.16; 34)).<h4>Conclusion</h4>Within the limitations of the current NMA, FFF, DCIA, Scapula, and ORFF showed a comparable survival rate for mandibular reconstruction. Although the scapula flap reported the highest survival rate compared to other osseous flaps for mandibular reconstruction; however, the decision making when choosing an osseous flap should be based on many factors rather than simply flap survival rate.
format	article
author	Mubarak Ahmed Mashrah Taghrid Aldhohrah Ahmed Abdelrehem Karim Ahmed Sakran Hyat Ahmad Hamada Mahran Faisal Abu-Lohom Hanfu Su Ying Fang Liping Wang
author_facet	Mubarak Ahmed Mashrah Taghrid Aldhohrah Ahmed Abdelrehem Karim Ahmed Sakran Hyat Ahmad Hamada Mahran Faisal Abu-Lohom Hanfu Su Ying Fang Liping Wang
author_sort	Mubarak Ahmed Mashrah
title	Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.
title_short	Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.
title_full	Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.
title_fullStr	Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.
title_full_unstemmed	Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.
title_sort	survival of vascularized osseous flaps in mandibular reconstruction: a network meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/7697ccdb8bad4a719e09356650b383d7
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Survival of vascularized osseous flaps in mandibular reconstruction: A network meta-analysis.

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