Long-term outcome in pediatric surgical bypass grafting after traumatic injury and tumor resection: retrospective cohort analysis.
Child
Female
Graft Occlusion, Vascular
/ physiopathology
Humans
Lower Extremity
/ physiopathology
Male
Neoplasms
/ physiopathology
Polytetrafluoroethylene
/ chemistry
Retrospective Studies
Saphenous Vein
/ physiopathology
Treatment Outcome
Upper Extremity
/ physiopathology
Vascular Grafting
/ methods
Vascular Patency
/ physiology
Vascular Surgical Procedures
/ methods
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
11 08 2021
11 08 2021
Historique:
received:
05
02
2021
accepted:
05
07
2021
entrez:
12
8
2021
pubmed:
13
8
2021
medline:
16
11
2021
Statut:
epublish
Résumé
Vascular bypass surgery in children differs significantly from adults. It is a rarely performed procedure in the setting of trauma and tumor surgery. Besides technical challenges to reconstruct the small and spastic vessels, another concern in bypass grafting is the adequate limb length growth over time. The primary aim of this study was to assess long-term outcome after pediatric bypass grafting, in a single academic center, focusing on potential effects on limb development. In this retrospective cohort analyses we included all pediatric patients undergoing vascular bypass grafting at our department between 2002 and 2017. All patients ≤ 18 years suffered a traumatic injury or underwent a tumor resection of the lower or upper limb. The youngest female patient was 0.4 years, the youngest male patient was 3.5 years. During the observation period, 33 pediatric patients underwent vascular repair, whereby 15 patients underwent bypass grafting. Median overall follow-up was 4.7 years (IQR ± 9). 8 patients (53%) had a traumatic injury (traumatic surgery group) and 7 patients had a planned orthopedic tumor resection (orthopedic surgery group). In 13/15 (87%) a great saphenous vein (GSV) graft and in 2/15 (13%) a Gore-Tex graft was used for bypassing. Both Gore-Tex grafts showed complete occlusion 12 and 16 years after implantation. No patient died in the early postoperative phase (< 30 days), however 3/7 (43%) in the orthopedic group died during follow-up. Revision surgery had to be performed in 1/15 (7%) patients. A functional use of the extremity was reported in all patients. Normal limb length growth according to the contralateral site, and therefore bypass growth, could be documented in 14/15 patients. Children are surgically challenging. In our study, surgery by a specialized vascular surgery team using GSV grafts led to adequate limb length and bypass growth, and we observed no functional restrictions.
Identifiants
pubmed: 34381065
doi: 10.1038/s41598-021-94971-2
pii: 10.1038/s41598-021-94971-2
pmc: PMC8357780
doi:
Substances chimiques
Polytetrafluoroethylene
9002-84-0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
16321Informations de copyright
© 2021. The Author(s).
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