Robbins M R, Hutchinson S A, Helmer S D
Department of Surgery, University of Kansas School of Medicine, Wichita 67214, USA.
Am J Surg. 1998 Dec;176(6):586-90. doi: 10.1016/s0002-9610(98)00288-8.
Autologous greater saphenous vein is considered to be the optimal material for peripheral arterial reconstruction and coronary artery revascularization. We describe a new endoscopic technique of saphenous vein harvest in infrainguinal arterial bypass surgery.
A retrospective analysis of 64 infrainguinal bypass procedures was performed comparing the standard open technique of saphenous vein harvesting with a new less invasive endoscopic technique.
There were no differences in age, gender, indications for surgery, or proximal or distal anastomosis between the two groups. There were also no significant differences in early wound complications, early patency, and transfusion requirements. In the endoscopic group, length of operation was longer (189 versus 158 minutes; P <0.005), length of stay was shorter (5.2 versus 8.1 days; P <0.05), and postoperative day of discharge was also less (3.3 versus 5.5 days; P <0.01).
Our findings indicate that endoscopic saphenectomy is technically feasible, leads to earlier discharge from the hospital, and leads to increased operative time. Most importantly, the procedure can be performed safely without subjecting the patient to increased risk.
自体大隐静脉被认为是外周动脉重建和冠状动脉血运重建的最佳材料。我们描述了一种在腹股沟下动脉搭桥手术中获取大隐静脉的新内镜技术。
对64例腹股沟下搭桥手术进行回顾性分析,比较大隐静脉获取的标准开放技术与一种新的微创内镜技术。
两组在年龄、性别、手术指征或近端或远端吻合方面无差异。早期伤口并发症、早期通畅率和输血需求方面也无显著差异。在内镜组,手术时间更长(189分钟对158分钟;P<0.005),住院时间更短(5.2天对8.1天;P<0.05),术后出院天数也更少(3.3天对5.5天;P<0.01)。
我们的研究结果表明,内镜下大隐静脉切除术在技术上是可行的,可使患者更早出院,并导致手术时间增加。最重要的是,该手术可以安全进行,而不会使患者面临更高风险。