Heydorn W H, Ferraris V A, Berry W R
Department of Surgery, Letterman Army Medical Center, Presidio of San Francisco, CA 94129-6700.
Ann Thorac Surg. 1988 Nov;46(5):567-9. doi: 10.1016/s0003-4975(10)64699-1.
Many thoracic surgeons have used pericardial substitutes to reduce the risk of reoperation, but there have been few reports of these procedures. Therefore, we used a questionnaire to gather information on experience with use of pericardial substitutes and to document the findings at reoperation. A six-question survey was sent to 2,344 members of The Society of Thoracic Surgeons, requesting surgeons to list their experience with pericardial substitutes and at reoperation in patients with these substitutes in place. Of the 634 surgeons who responded to the survey, 120 reported the insertion of 3,828 pericardial substitutes. Two hundred thirty-six reoperations were reported by 89 surgeons. None of the pericardial substitutes was reported to be completely successful in facilitating reoperation. The experience with polytetrafluoroethylene (PTFE) pericardial substitutes was reported to be significantly more satisfactory than that with all other substitutes (p = 0.0004 by chi-square analysis), but 14% of surgeons who used PTFE said they were dissatisfied at reoperation. Based on the results of this survey, we suggest caution, careful documentation, and long-term follow-up studies before widespread use of pericardial substitutes can be recommended.
许多胸外科医生使用心包替代物来降低再次手术的风险，但关于这些手术的报道很少。因此，我们通过问卷调查收集了使用心包替代物的经验信息，并记录了再次手术时的发现。我们向2344名胸外科医师协会成员发送了一份包含六个问题的调查问卷，要求外科医生列出他们使用心包替代物的经验以及对植入这些替代物的患者进行再次手术时的发现。在回复调查的634名外科医生中，有120名报告植入了3828个心包替代物。89名外科医生报告了236例再次手术。据报道，没有一种心包替代物在促进再次手术方面完全成功。据报道，聚四氟乙烯（PTFE）心包替代物的使用经验比所有其他替代物都要明显更令人满意（经卡方分析，p = 0.0004），但使用PTFE的外科医生中有14%表示他们对再次手术不满意。基于这项调查的结果，我们建议在广泛推荐使用心包替代物之前要谨慎、仔细记录并进行长期随访研究。
