Použití metody endoskopického odběru velké safény v periferní infrainguinální cévní chirurgii – zhodnocení našich iniciálních zkušeností
| Autoři | |
|---|---|
| Rok publikování | 2016 |
| Druh | Další prezentace na konferencích |
| Fakulta / Pracoviště MU | |
| Citace | |
| Popis | Objective: We describe our initial experience and early results of infrainguinal arterial bypasses done using technique of endoscopic vein harvest (EVH). Methods: All patients who underwent endoscopic great saphenous vein harvest for lower extremity arterial bypass grafting were enrolled in this study. Selection of patients for EVH was based on clinical and duplex ultrasound appearance of a great saphenous vein (GSV). Only patients with adequate GSV were considered for EVH. We collected data regarding patient’s demographics, history, clinical findings, operative procedure and postoperative recovery. Patients were followed at 3, 6, 12, 18 and 24 months postoperatively and then yearly thereafter. Patencies were analyzed by Kaplan-Meier method. Statistical analysis was performed using IBM SPSS Statistics 21.0 software (IBM Corp, Armonk, NY). Results: From April 2012 to December 2015, 17 patients underwent 17 femoropopliteal bypass operations with GSV harvested by endoscopic technique. There were 15 male (88.2 %) and 2 female (11.8 %) patients, with a mean age of 60 years. Diabetes mellitus was present in 7 patients (41.2 %). The indication for intervention was critical limb ischemia in 7 patients (41.2 %) and life-limiting claudication in 10 patients (58.8 %). One patient underwent conversion to open harvest after endoscopic dissection of the vein. All other GSV harvests were accomplished endoscopically. Harvested GSV was utilised for formation of proximal (11; 64.7 %) or distal (6; 35.3 %) femoropopliteal bypass. 2 patients (11.8 %) developed postoperative surgical site infection Szilagyi gr. II. Mean follow-up was 10.2 months. At 1 and 2 years, primary patency was 82.0 % and 82.0 %, assisted primary patency was 93.8 % and 93.8 %, and secondary patency was 100.0 % and 100.0 %. At 1 and 2 years, amputation-free survival was 100.0 % and 100.0 %. No patient died within the study period (mortality 0.0 %). Conclusions: Endoscopic harvest of GSV is a minimally invasive alternative of a standard open harvest of GSV. In our early experience, results of EVH femoropopliteal bypasses are comparable to those achieved using traditional open vein harvest technique with the added benefit of decreased incidence of surgical site infections and decreased invasivity of the procedure. |