Algharib Ahmed, Koning Giel G, van Dortmont Lourina M C, Riedel Sandra, Möller Rüdiger
Abteilung für Gefäßchirurgie, Euregio-Klinik, Nordhorn, Deutschland.
Zentralbl Chir. 2024 Oct;149(5):475-478. doi: 10.1055/a-2206-2353. Epub 2023 Nov 23.
Amputations are always considered "the last option" for patients with vascular diseases. Currently, in Germany, more than 4.5 million patients suffer from diabetes mellitus. Since we introduced the minimally invasive concept for the treatment of diabetic foot syndrome, we have observed, after careful evaluation, a decreasing trend in the rates of minor and major amputations.Ethics and informed consent were ensured in this retrospective evaluation. Approximately 150 patients with complex diabetic foot syndrome are treated annually. Since July 2021, we have been treating our patients with a minimally invasive concept as one of several multidisciplinary modalities. For evaluation, we included and analyzed our diabetic patients who underwent minor and major amputations within the defined time frames from 2018 to 2023 (including revision amputations). We compared the most recent 30 months (group 2) since the introduction of this concept with the preceding 30 months (group 1).A total of 810 patients with any form of diabetic foot syndrome presented at our clinic between 2018 and 2023, of which 242 patients required primary surgical treatment. Patients in group 1 exhibited a major amputation rate of 4%, a minor amputation rate of 13%, and an overall revision surgery rate of 4%. Patients in group 2 displayed a major amputation rate of 2%, a minor amputation rate of 10%, and an overall revision surgery rate of 2%.After the introduction of the minimally invasive concept as an adjustment to our multidisciplinary approach for treating patients with diabetic foot syndrome, we have observed, through our critical evaluation, a declining trend in both minor and major amputation rates. While further research is necessary to confirm or reject our results, the implementation of minimally invasive surgery into the toolkit of regional hospitals may significantly contribute to an improved health status for patients.
截肢一直被视为血管疾病患者的“最后选择”。目前，德国有超过450万糖尿病患者。自从我们引入微创概念来治疗糖尿病足综合征以来，经过仔细评估，我们观察到小截肢和大截肢的发生率呈下降趋势。在这项回顾性评估中确保了伦理和知情同意。每年大约有150例患有复杂糖尿病足综合征的患者接受治疗。自2021年7月以来，我们一直将微创概念作为多种多学科治疗方式之一来治疗患者。为了进行评估，我们纳入并分析了在2018年至2023年规定时间内接受小截肢和大截肢的糖尿病患者（包括翻修截肢）。我们将引入该概念后的最近30个月（第2组）与之前的30个月（第1组）进行了比较。2018年至2023年期间，共有810例患有任何形式糖尿病足综合征的患者到我们诊所就诊，其中242例患者需要进行一期手术治疗。第1组患者的大截肢率为4%，小截肢率为13%，总体翻修手术率为4%。第2组患者的大截肢率为2%，小截肢率为10%，总体翻修手术率为2%。在引入微创概念作为我们治疗糖尿病足综合征患者多学科方法的一种调整后，通过我们的严格评估，我们观察到小截肢和大截肢率均呈下降趋势。虽然需要进一步研究来证实或反驳我们的结果，但将微创手术纳入地区医院的工具包可能会显著改善患者的健康状况。
