Abstract: Objective To systematically evaluate the effect of delayed autologous breast reconstruction in the treatment of upper limb lymphedema. Methods The databases of Cochrane Library, PubMed, Embase, Scopus and Web of Science were searched to collect studies on therapeutic effect of delayed autologous breast reconstruction on upper limb lymphedema from the inception to June 2020. The eligible articles were independently screened by two researchers and the data were extracted. The quality of the included literature was evaluated by the literature quality evaluation tool of the JBI, and the RevMan5.3 software was used for Meta analysis. Results Eleven articles were included, of which six were quantitative synthetic analysis. Meta analysis showed that 64.8%(95% confidence interval, 0.32~0.88) of the patients reduced lymphedema after breast reconstruction whether they received lymph node transplantation or not. Subgroup analysis showed that 84.4% (95% confidence interval, 0.72~0.92) of patients reduced lymphedema after breast reconstruction and lymph node transplantation,while only 21.9%(95% confidence interval,0.14~0.33) reduced lymphedema after breast reconstruction. Conclusion Delayed autologous breast reconstruction can improve upper limb lymphedema in patients with breast cancer, and lymph node transplantation may be the largest contributing factor leading to lymphedema improvement.

Key words: breast reconstruction, breast cancer, lymphedema, Meta analysis