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内镜下静脉采集在肥胖患者冠状动脉旁路移植术中的应用。

Application of Endoscopic Vein Harvesting in Obese Patients Undergoing Coronary Artery Bypass Grafting.

机构信息

Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

出版信息

Curr Med Sci. 2018 Aug;38(4):691-696. doi: 10.1007/s11596-018-1932-z. Epub 2018 Aug 20.

DOI:10.1007/s11596-018-1932-z
PMID:30128880
Abstract

This study aims to evaluate the clinical outcomes of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in obese patients. Totally, 153 obese patients who underwent EVH (n=81) or standard bridging technique (SBT, n=12) in CABG surgery from May 2012 to October 2014 in our hospital were enrolled in this retrospective non-randomized controlled study. The general situation of operation, postoperative complications and short medium-term outcomes were analyzed. The baseline characteristics were similar between these two groups (P>0.05). There were no statistical differences in total operation time (226±28 min vs. 224±30 min, P>0.05), number of damaged vessels (0.12±0.05 vs. 0.16±0.06,P>0.05) and short medium-term outcomes including revascularization rate (1.25% vs. 2.78%, i 0.05), vessel dysfunction rate (11.25% vs. 11.11%,P>0.05) and mortality (0.00% v . 0.00%, P>0.05). Use of EVH was associated with significant reduction of total harvesting time (41 ±6 min vs. 63± 11 min, P<0.05), incision length (4.4±1.1 cm 18.2±4.5 cm, P<0.05) and postoperative lower extremity complications (P<0.05). EVH can reduce the risk of wound complications, whereas does not influence short- and medium-term outcomes in obese patients. It can be considered a reliable procedure of harvesting vessel conduits for obese patients undergoing CABG.

摘要

本研究旨在评估内镜静脉采集(EVH)在肥胖患者冠状动脉旁路移植术(CABG)中的临床效果。共有 153 例肥胖患者在我院接受了 CABG 手术,其中 81 例采用 EVH(n=81),12 例采用标准桥接技术(SBT,n=12)。回顾性非随机对照研究。分析了手术的一般情况、术后并发症和中短期结果。两组患者的基线特征相似(P>0.05)。总手术时间(226±28 分钟与 224±30 分钟,P>0.05)、损伤血管数(0.12±0.05 与 0.16±0.06,P>0.05)和中短期结果,包括血运重建率(1.25%与 2.78%,i 0.05)、血管功能障碍率(11.25%与 11.11%,P>0.05)和死亡率(0.00%与 0.00%,P>0.05)均无统计学差异。EVH 的使用与总采集时间(41±6 分钟与 63±11 分钟,P<0.05)、切口长度(4.4±1.1 厘米与 18.2±4.5 厘米,P<0.05)和术后下肢并发症减少显著相关(P<0.05)。EVH 可降低伤口并发症风险,而对肥胖患者 CABG 的短期和中期结果无影响。对于接受 CABG 的肥胖患者,EVH 可以被认为是一种可靠的血管采集方法。

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Major adverse cardiac and cerebrovascular event and patients' quality of life after endoscopic vein harvesting as compared with open vein harvest (MAQEH): a pilot study.内镜下静脉采集与开放静脉采集相比的主要不良心脑血管事件及患者生活质量(MAQEH):一项前瞻性研究。
Open Heart. 2018 Jan 9;5(1):e000694. doi: 10.1136/openhrt-2017-000694. eCollection 2018.
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Complications of CO insufflation during endoscopic vein harvesting.内镜下静脉采集过程中二氧化碳充气的并发症。
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Endoscopic Conduit Harvest in Coronary Artery Bypass Grafting Surgery: An ISMICS Systematic Review and Consensus Conference Statements.
冠状动脉旁路移植手术中内镜下获取血管桥:国际微创心血管外科学会系统评价与共识会议声明
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Coronary artery bypass grafting: Part 2--optimizing outcomes and future prospects.冠状动脉旁路移植术:第 2 部分——优化结果和未来前景。
Eur Heart J. 2013 Oct;34(37):2873-86. doi: 10.1093/eurheartj/eht284.
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The influence of endoscopic vein harvesting on outcomes after coronary bypass grafting: a meta-analysis of 267,525 patients.内镜静脉采集对冠状动脉旁路移植术后结果的影响:267525 例患者的荟萃分析。
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Endoscopic vein-graft harvest is safe for CABG surgery.内镜下静脉移植物获取对于冠状动脉旁路移植术(CABG)手术是安全的。
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