کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5958319 1575453 2014 19 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Endoscopic Vein Harvesting in Lower Extremity Arterial Bypass: A Systematic Review
ترجمه فارسی عنوان
برداشتن وین اندوسکوپیک در بای پس عروق کمر: یک بررسی سیستماتیک
کلمات کلیدی
بای پس عروق آندوسکوپی، اندواسکوپیک، اندام تحتانی، اختراع، بررسی سیستماتیک، برداشت وین، التیام زخم،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

ObjectiveEndoscopic vein harvesting (EVH) for arterial bypass surgery may be associated with lower wound complication rates than open vein harvesting (OVH), but other long-term outcomes remain controversial, and there are concerns that graft patency may be poorer after EVH compared with OVH. We conducted a systematic review of all available evidence for EVH in lower extremity arterial bypass (LEAB).MethodsA literature search of Medline, Embase, Ovid and Cochrane databases between 1996 and 2013 was performed using the terms “endoscopic vein harvesting”, “minimally invasive vein harvest”, “peripheral bypass surgery”, and “lower extremity bypass surgery”, and detailed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Primary outcomes were graft patency and overall wound complication rates. Secondary outcomes were wound infection, length of hospital stay, and cost-effectiveness. Summary estimates were calculated by random effects meta-analysis if sufficient data were available.ResultsWe identified 18 cohort studies and case series, with considerable clinical heterogeneity, including 2,343 patients. Meta-analysis of six studies revealed a significantly reduced rate of primary patency after EVH (hazard ratio 1.29, 95% confidence interval [CI] 1.03-1.63), with no significant difference between EVH and OVH with respect to wound infection in 12 studies (odds ratio 0.81, 95% CI 0.61-1.08). There was a lack of strong evidence to support the secondary outcomes of EVH.ConclusionEVH reduces primary patency rates after LEAB, but does not demonstrate an advantage with respect to postoperative wound complications. However, the available data are heterogeneous, and uncertainty is introduced by both evolution in technology and increasing technical experience. EVH should be used with caution and in the context of formal research.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Journal of Vascular and Endovascular Surgery - Volume 47, Issue 6, June 2014, Pages 621-639
نویسندگان
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