内镜静脉收获及其对下肢动脉绕道通透性的影响
Justin M Robbins1, Charles Cush1, Brian Schutter1
1Department of Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH.
Journal of vascular surgery
|April 5, 2025
概括
透视静脉采摘 (EVH) 显示了类似的移植通透性,以开放静脉采摘 (OVH) 的下肢动脉绕道. EVH提供了更短的手术时间和更少的伤口并发症,使其成为由经验丰富的提供者进行时有希望的替代方案.
科学领域:
- 血管外科 血管外科
- 最少侵入性的技术
- 移植的宽容性 移植的宽容性
背景情况:
- 内镜静脉摘取 (EVH) 是用于下肢动脉绕道的开放静脉摘取 (OVH) 的替代方案.
- 由于潜在的静脉损伤,人们对EVH的长期移植通透性存在担忧.
- 在减少伤口并发症方面,EVH可能具有优势.
研究的目的:
- 为了比较使用EVH与OVH收获的大沙静脉移植的长期通透率.
- 评估收获技术对伤口并发症率和修复程序的需要的影响.
主要方法:
- 对340名使用大沙静脉进行下 inguinal 绕道手术的患者的回顾性研究 (2013-2023年).
- 对OVH (n=111) 和EVH (n=229) 组进行比较.
- 评估初级,初级辅助和二级通透率,伤口并发症和手术时间.
主要成果:
- 在EVH和OVH之间,初级 (43.8%EVH与49.6%OVH),初级辅助 (89.0%与91.0%) 或二次通透率 (81%与75.0%) 没有显著差异.
- EVH组的切口破裂率显著降低 (11.9%对21.1%),并减少了绕道失败的几率.
- 与OVH (228分钟) 相比,EVH (193分钟) 的平均操作时间更短.
结论:
- 对于下肢动脉绕道,EVH的长期移植通透性与OVH的长期移植通透性相当.
- EVH与手术时间缩短和伤口并发症减少有关.
- EVH是静脉摘取的可行和有前途的选择,特别是当经验丰富的外科医生进行时.
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