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The value of obturator canal bypass. A review
T Sautner1, B Niederle, F Herbst
1Department of Surgery, University of Vienna Medical School, Austria.
Objective:
To review the value of obturator canal bypass with respect to long-term results.
Design:
Case series and literature review.
Setting:
University of Vienna Medical School in Austria.
Patients/Methods:
Personal experience with 34 consecutive patients and 125 cases published since 1982 with respect to patient data, patency, and survival are compared and jointly analyzed retrospectively.
Interventions:
Patients received obturator canal bypass for lesions of the pelvic or common femoral vessels precluding orthotopic reconstruction.
Main Outcome Measures:
The rates of patient survival, limb salvage, and graft patency were analyzed.
Results:
The postoperative mortality rate in the present series was 14.7%. The limb salvage rate after 5 years was 76.5%. One- and 5-year secondary patency rates were 75.3% and 54.9%, respectively. All grafts in patients without atherosclerosis were patent at a median of 34 months. For 57 cases documented in the literature, 1- and 5-year patency rates were 70.8% and 59.7%, respectively. Combined analysis of 90 obturator canal bypasses revealed rates of 72.7% and 56.9% of patent grafts at 1- and 5-years, respectively.
Conclusions:
The use of obturator canal bypass is recommended in deep groin infections and especially in patients with lesions of the pelvic vessels due to other occlusive vascular disease.