123 The Effect of Sarcopenia on Postoperative Complications in Autologous Breast Reconstruction – A Systematic Review and Meta-Analysis Free

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 breast reconstruction.

A systematic review of electronic databases was performed in conjunction with 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.

Six studies were included in meta-analysis. Sarcopenic patients were found to be at a significantly increased risk of haematoma formation (OR= 1.84, 95%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 re-operation nor wound dehiscence between sarcopenic and non-sarcopenic cohorts.

This study reports that haematoma risk is significantly elevated in sarcopenic patients undergoing autologous breast reconstruction. Postoperative complication rates are otherwise comparable between sarcopenic and non-sarcopenic cohorts. Further prospective studies reporting on BMI, PMA and psoas muscle density are required.