Student's Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Students Research Committee, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Langenbecks Arch Surg. 2024 Aug 15;409(1):252. doi: 10.1007/s00423-024-03407-8.
Traumatic injuries affecting the veins in the lower extremities have been correlated with both mortality and severe complications. Venous injuries are recognized as a contributing factor to the development of venous thromboembolism, commonly treated through procedures involving either vein ligation or repair. Despite previous efforts, substantial uncertainty remains when it comes to choosing between the execution of ligation versus various reparative techniques. The aim of this study was to evaluate the short-term results of surgically treating traumatic venous injuries through repair compared to ligation, specifically examining the resulting impacts on trauma patients in relation to DVT and PE occurrences.
A comprehensive search strategy was employed until August 10, 2023, to systematically explore Scopus and PubMed databases. Following the removal of duplicates, two researchers independently assessed the titles and abstracts of the identified studies. Only studies meeting the project's requirements and inclusion criteria, as evaluated through their full texts, were included in our investigation. Our study exclusively focused on original articles, specifically those involving human trauma patients with isolated popliteal vein injuries. Excluded from consideration were review articles, meta-analyses, cellular and molecular research, animal studies, case reports, case series, letters to the editor, posters, duplicates, and publications in languages other than English. The implementation of this systematic review and meta-analysis conformed to the standards delineated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Conducting a thorough search, the inquiry identified 248 records. The assessment of titles and abstracts led to 51 studies that had the potential for eligibility. After reviewing the full texts of the chosen studies, 4 studies involving 1521 patients constituted the ultimate findings.
We concluded that the ligation procedure had a higher incidence of pulmonary embolism compared to the repair of vein injuries, while the repair procedure had a higher incidence of deep vein thrombosis than ligation. Additional large-scale randomized controlled trials are still necessary to further support the findings of this meta-analysis.
下肢静脉创伤与死亡率和严重并发症密切相关。静脉损伤被认为是静脉血栓栓塞发展的一个促成因素，通常通过静脉结扎或修复等程序进行治疗。尽管之前已经做了很多努力，但在选择结扎与各种修复技术之间仍然存在很大的不确定性。本研究旨在评估通过修复而非结扎治疗创伤性静脉损伤的短期结果，具体研究修复对创伤患者深静脉血栓形成和肺栓塞发生的影响。
我们采用全面的搜索策略，截至 2023 年 8 月 10 日，系统地检索了 Scopus 和 PubMed 数据库。在去除重复项后，两名研究人员独立评估了确定研究的标题和摘要。只有符合项目要求并通过全文评估符合纳入标准的研究才被纳入我们的研究。我们的研究仅关注原始文章，特别是涉及孤立腘静脉损伤的人类创伤患者的文章。排除标准包括综述文章、荟萃分析、细胞和分子研究、动物研究、病例报告、病例系列、给编辑的信、海报、重复发表以及非英文出版物。本系统评价和荟萃分析的实施符合系统评价和荟萃分析报告的首选项目（PRISMA）标准。
经过全面检索，查询共确定了 248 条记录。评估标题和摘要后，有 51 项研究具有潜在的入选资格。在对入选研究的全文进行评估后，最终纳入了 4 项涉及 1521 例患者的研究。
我们的结论是，与静脉损伤修复相比，结扎术的肺栓塞发生率更高，而修复术的深静脉血栓形成发生率高于结扎术。仍需要进行更大规模的随机对照试验，以进一步支持本荟萃分析的结果。
