Imperial College London

Mr Daniel Richard Leff

Faculty of MedicineDepartment of Surgery & Cancer

Reader in Breast Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1947d.leff

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Berthelot:2019:10.1097/GOX.0000000000002437,
author = {Berthelot, M and Ashcroft, J and Boshier, P and Henry, FP and Hunter, J and Lo, B and Yang, G-Z and Leff, D},
doi = {10.1097/GOX.0000000000002437},
journal = {Plastic and Reconstructive Surgery Global Open},
pages = {1--8},
title = {Use of near infrared spectroscopy and implantable Doppler for postoperative monitoring of free tissue transfer for breast reconstruction: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1097/GOX.0000000000002437},
volume = {7},
year = {2019}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - Background: Failure to accurately assess the perfusion of free tissue transfer (FTT) in the early postoperative periodmay contribute to failure, which is a source of major patient morbidity and healthcare costs.Goal: This systematic review and meta-analysis aims to evaluate and appraise current evidence for the use of nearinfrared spectroscopy (NIRS) and/or implantable Doppler (ID) devices compared with conventional clinicalassessment (CCA) for postoperative monitoring of FTT in reconstructive breast surgery.Methods: A systematic literature search was performed in accordance with the PRISMA guidelines. Studies in humansubjects published within the last decade relevant to the review question were identified. Meta-analysis using randomeffects models of FTT failure rate and STARD scoring were then performed on the retrieved publications.Results: 19 studies met the inclusions criteria. For NIRS and ID, the mean sensitivity for the detection of FTT failure is99.36% and 100% respectively, with average specificity of 99.36% and 97.63% respectively. From studies withsufficient reported data, meta-analysis results demonstrated that both NIRS (OR = 0.09 [0.02, 0.36], P < 0.001) and ID(OR = 0.39 [0.27, 0.95], P = 0.04) were associated with significant reduction of FTT failure rates compared to CCA.Conclusion: The use of ID and NIRS provide equivalent outcomes in detecting FTT failure and were superior to CCA.The ability to acquire continuous objective physiological data regarding tissue perfusion is a perceived advantage ofthese techniques. Reduced clinical staff workload and minimised hospital costs are also perceived as positiveconsequences of their use.
AU - Berthelot,M
AU - Ashcroft,J
AU - Boshier,P
AU - Henry,FP
AU - Hunter,J
AU - Lo,B
AU - Yang,G-Z
AU - Leff,D
DO - 10.1097/GOX.0000000000002437
EP - 8
PY - 2019///
SN - 2169-7574
SP - 1
TI - Use of near infrared spectroscopy and implantable Doppler for postoperative monitoring of free tissue transfer for breast reconstruction: a systematic review and meta-analysis
T2 - Plastic and Reconstructive Surgery Global Open
UR - http://dx.doi.org/10.1097/GOX.0000000000002437
UR - https://insights.ovid.com/crossref?an=01720096-201910000-00019
UR - http://hdl.handle.net/10044/1/71943
VL - 7
ER -