Khan Muhammad Shahzeb, Bawany Faizan Imran, Khan Asadullah, Hussain Mehwish, Islam Mohammad Yousuf Ul, Lashari Muhammad Nawaz
Dow University of Health Sciences (DUHS), Karachi, Pakistan.
Cardiac Surgery Department, Civil Hospital, Dow University of Health Sciences (DUHS), Karachi, Pakistan.
Int J Angiol. 2015 Dec;24(4):262-7. doi: 10.1055/s-0035-1554800. Epub 2015 Jun 5.
It remains a controversial issue whether internal thoracic artery (ITA) should be dissected in skeletonized or pedicled manner during coronary artery bypass graft (CABG) surgery. The main objective of this cohort study was to compare skeletonized versus pedicled grafts on the basis of patients' perceptions of their physical and mental well-being. Isolated nonemergent CABG patients were divided into two groups according to the type of graft used; skeletonized or pedicled. The quality of life (QOL) was measured preoperatively, 6 months postoperatively, and 12 months postoperatively for each patient using the 36-Item Short Form Health Survey tool. The main outcome variables were physical component summary (PCS) score and mental component summary (MCS) score. A total of 140 patients were included in the study with 70 patients in each group. The PCS (p-value = 0.235) and MCS (p-value = 0.239) scores of patients were similar in both the groups before CABG. The PCS and MCS scores were significantly (p-values < 0.0001) improved after CABG at 6 months in both the groups. However, the PCS and MCS scores in the skeletonized group were significantly higher (p-values < 0.0001) than the scores in the pedicled group at 6 and 12 months post-CABG. Both the harvesting techniques improve QOL significantly after CABG. However, skeletonization results in significantly better PCS and MCS scores compared with pedicled harvesting technique.
在冠状动脉旁路移植术(CABG)手术中,胸廓内动脉(ITA)应以骨骼化方式还是带蒂方式进行解剖,仍是一个有争议的问题。这项队列研究的主要目的是根据患者对其身心健康的感知,比较骨骼化移植物和带蒂移植物。将孤立的非急诊CABG患者根据所使用的移植物类型分为两组;骨骼化组或带蒂组。使用36项简明健康调查工具在术前、术后6个月和术后12个月对每位患者的生活质量(QOL)进行测量。主要结局变量是身体成分总结(PCS)评分和心理成分总结(MCS)评分。共有140名患者纳入研究,每组70名患者。在CABG术前,两组患者的PCS(p值 = 0.235)和MCS(p值 = 0.239)评分相似。两组患者在CABG术后6个月时,PCS和MCS评分均显著改善(p值 < 0.0001)。然而,在CABG术后6个月和12个月时,骨骼化组的PCS和MCS评分显著高于带蒂组(p值 < 0.0001)。两种获取技术在CABG术后均显著改善了QOL。然而,与带蒂获取技术相比,骨骼化导致PCS和MCS评分显著更好。