{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:04:54Z","timestamp":1784091894041,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autologous breast reconstruction provides superior long\u2010term outcomes compared with implant\u2010based techniques, particularly, in patients requiring radiotherapy. Although abdominal\u2010based flaps remain the gold standard, many patients are unsuitable candidates, necessitating alternative donor sites. The superior gluteal artery perforator (SGAP) and lumbar artery perforator (LAP) flaps are established nonabdominal options; however, comparative outcome data remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis were performed according to PRISMA guidelines. Major electronic databases were searched for studies published up to January 2026 reporting outcomes of SGAP and\/or LAP flaps in oncologic breast reconstruction. Random\u2010effects meta\u2010analyses of proportions were used to calculate pooled estimates for total flap loss, overall complications, donor\u2010site seroma, and vessel graft utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010three studies met inclusion criteria, including 14 SGAP and 9 LAP series, comprising 475 SGAP and 440 LAP patients. Pooled total flap loss rates were 3.9% (95% CI, 2.1%\u20136.1%) for SGAP flaps and 9.7% (95% CI, 6.6%\u201313.2%) for LAP flaps (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0016). Overall complication rates were lower for SGAP flaps (35.5%; 95% CI, 24.0%\u201347.9%) than for LAP flaps (55.2%; 95% CI, 44.7%\u201365.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Donor\u2010site seroma occurred in 26.5% of SGAP and 33.3% of LAP reconstructions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Vessel graft utilization was uncommon in SGAP reconstruction (1.5%) but routine in LAP reconstruction (97.9%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both SGAP and LAP flaps are reliable nonabdominal options for autologous breast reconstruction. However, differences in flap loss, complication profiles, donor\u2010site morbidity, and technical demands highlight the need for individualized flap selection based on patient anatomy and microsurgical expertise.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      PROSPERO number: 559731\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70847","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:13:31Z","timestamp":1784088811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Superior Gluteal and Lumbar Artery Perforator Flaps in Autologous Breast Reconstruction: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2757-2247","authenticated-orcid":false,"given":"Mehmet Emin Cem","family":"Yildirim","sequence":"first","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine Nisantasi University  Istanbul Turkey"},{"name":"Private Clinic  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilker","family":"Uyar","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine Izmir Tinaztepe University  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-7338","authenticated-orcid":false,"given":"Suat","family":"Morkuzu","sequence":"additional","affiliation":[{"name":"Institute for Reconstructive Surgery, Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Dadaci","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine Necmettin Erbakan University  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilsev","family":"Ince","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine Necmettin Erbakan University  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Blondeel","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery Gent University  Gent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/bs.pmbts.2017.07.002","article-title":"Breast Cancer Epidemiology, Prevention, and Screening","volume":"151","author":"Winters S.","year":"2017","journal-title":"Progress in Molecular Biology and Translational Science"},{"issue":"10","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000002486","article-title":"A Meta\u2010Analysis of Clinical, Patient\u2010Reported Outcomes and Cost of DIEP Versus Implant\u2010Based Breast Reconstruction","volume":"7","author":"Khajuria A.","year":"2019","journal-title":"Plastic and Reconstructive Surgery. Global Open"},{"issue":"3","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/13548500701405509","article-title":"Body Image Issues in Women With Breast Cancer","volume":"13","author":"Helms R. L.","year":"2008","journal-title":"Psychology, Health & Medicine"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1054\/bjps.1998.3032","article-title":"The Sensate Free Superior Gluteal Artery Perforator (S\u2010GAP) Flap: A Valuable Alternative in Autologous Breast Reconstruction","volume":"52","author":"Blondeel P. 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M.","year":"2025","journal-title":"Journal of Plastic, Reconstructive & Aesthetic Surgery"},{"issue":"9","key":"e_1_2_9_27_1","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000006188","article-title":"Anatomical Analysis of the Superior Gluteal Artery in 100 Women for Superior Gluteal Artery Perforator Flap Breast Reconstruction","volume":"12","author":"Aoki H.","year":"2024","journal-title":"Plastic and Reconstructive Surgery. 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