Rahouma Mohamed, Kamel Mohamed, Benedetto Umberto, Ohmes Lucas B, Di Franco Antonino, Lau Christopher, Girardi Leonard N, Tranbaugh Robert F, Barili Fabio, Gaudino Mario
Department of Cardio-Thoracic Surgery, Weill Cornell Medicine, New York, NY.
Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom.
J Card Surg. 2017 Jun;32(6):334-341. doi: 10.1111/jocs.13148. Epub 2017 May 17.
We sought to investigate the impact of radial artery harvesting techniques on clinical outcomes using a meta-analytic approach limited to randomized controlled trials and propensity-matched studies for clinical outcomes, in which graft patency was analyzed.
A systematic literature review was conducted using PubMed and MEDLINE to identify publications containing comparisons between endoscopic radial artery harvesting (ERAH) and open harvesting (ORAH). Only randomized controlled trials and propensity-matched series were included. Data were extracted and analyzed with RevMan. The primary endpoint was wound complication rate, while secondary endpoints were patency rate, early mortality, and long-term cardiac mortality.
Six studies comprising 743 patients were included in the meta-analysis. Of them 324 (43.6%) underwent ERAH and 419 (56.4%) ORAH. ERAH was associated with a lower incidence of wound complications (odds ratio: 0.33, confidence interval 0.14-0.77; p = 0.01). There were no differences in graft patency, and early and long-term cardiac mortality between the two techniques.
ERAH reduces wound complications and does not affect graft patency, or short- and long-term mortality compared to ORAH.
我们试图采用荟萃分析方法，研究桡动脉获取技术对临床结局的影响，该方法仅限于对临床结局进行随机对照试验和倾向匹配研究，并对移植物通畅情况进行分析。
使用PubMed和MEDLINE进行系统文献综述，以识别包含内镜下桡动脉获取（ERAH）与开放获取（ORAH）比较的出版物。仅纳入随机对照试验和倾向匹配系列研究。使用RevMan提取并分析数据。主要终点是伤口并发症发生率，次要终点是通畅率、早期死亡率和长期心脏死亡率。
荟萃分析纳入了6项研究，共743例患者。其中324例（43.6%）接受了ERAH，419例（56.4%）接受了ORAH。ERAH与较低的伤口并发症发生率相关（比值比：0.33，置信区间0.14 - 0.77；p = 0.01）。两种技术在移植物通畅率、早期和长期心脏死亡率方面没有差异。
与ORAH相比，ERAH可减少伤口并发症，且不影响移植物通畅率或短期和长期死亡率。
