Non-Cochrane · intervention · PM42123189
Anterolateral Thigh Flap and Bone Plate for Mandibular Reconstruction in Patients over 55 Undergoing Ablative Oral Surgery: A Systematic Review and Meta-Analysis.
Nocini Riccardo, Papi Giacomo, Gobbo Giulia, et al. · Journal of clinical medicine · 2026 · PubMed · doi:10.3390/jcm15093457
Findings
Population Patients aged 55 years or older undergoing mandibular reconstruction after ablative oral surgery
5 findings
| Anterolateral thigh flap with titanium reconstruction plate | None (single-arm proportions) | Plate-related complication rate Hospital · Sensitivity analysis: excluding Bowe et al. 2021 | Proportion 0.33 [0.25, 0.40] GRADE not reported 3 studies · 203 participants |
| Anterolateral thigh flap with titanium reconstruction plate | None (single-arm proportions) | Overall complication rate Hospital | Proportion 0.52 [0.26, 0.78] Very low Downgraded: risk of bias, inconsistency 4 studies · 233 participants |
| Anterolateral thigh flap with titanium reconstruction plate | None (single-arm proportions) | Overall complication rate Hospital · Sensitivity analysis: excluding Bowe et al. 2021 | Proportion 0.65 [0.48, 0.81] GRADE not reported 3 studies · 203 participants |
| Anterolateral thigh flap with titanium reconstruction plate | None (single-arm proportions) | Plate-related complication rate Hospital | Proportion 0.28 [0.15, 0.40] Very low Downgraded: risk of bias, inconsistency 4 studies · 233 participants |
| Anterolateral thigh flap with titanium reconstruction plate | None (single-arm proportions) | Flap success rate Hospital | Proportion 0.97 [0.92, 0.99] Very low Downgraded: risk of bias, inconsistency 4 studies · 233 participants |
Included primary studies 4
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bowe 2021 Lateral segmental mandibulectomy reconstruction with bridging reconstruction plate and anterolateral thigh free flap: a case series of 30… PMID:33436152 | 2021 | this review only | not stated | not extracted yet |
| Chang 2023 Plate-related complication and health-related quality of life after mandibular reconstruction by fibula flap with reconstruction plate or… PMID:35553089 | 2023 | this review only | not stated | not extracted yet |
| Huang 2021 Comparison of surgical outcomes between primary plate and fibular flap transfer for reconstruction of segmental mandibular defects. PMID:33682153 | 2021 | this review only | not stated | not extracted yet |
| Offodile 2018 Anterolateral Thigh Flap Combined with Reconstruction Plate Versus Double Free Flaps for Composite Mandibular Reconstruction: A Propensity… PMID:29288289 | 2018 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients aged 55 years or older with mandibulectomy for oral or head and neck cancer or benign disease | Patients with mandibular reconstruction after ablative oral surgery, mean age over 55 years (n=329) |
| Intervention | Mandibular reconstruction with ALT flap and titanium reconstruction plate | ALT flap with reconstruction plate (n=233 in meta-analysis) |
| Comparison | Not considered (single-arm) | None (comparator arms excluded) |
| Outcomes | Clinical success rate; complication rate (primary); complication type and hospital stay (secondary) | Flap success; plate-related complications; overall complications; hospital stay 10 to 24 days |
| Study designs | Studies with at least 20 patients; mean age 55 years or older; retrospective or prospective, English language | 4 retrospective studies (3 cohort, 1 case series) |
| Timing | Not specified | Follow-up 6 months to 96 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: Partial Yes | RCT: N/A · NRSI: Partial Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: Yes | RCT: N/A · NRSI: Yes | yes |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |