COMPARING THE OUTCOMES OF CABG SURGERY ACCORDING TO THE STRATIFIED SYNTAX SCORE
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1431Keywords:
Coronary Artery Bypass Grafting, Cabg, Coronary Artery DiseaseAbstract
Hydrocele management techniques such as Jaboulay’s procedure and hydrocelectomy with sac excision using a vessel sealing device are commonly employed. However, their comparative outcomes in terms of post-operative complications and recovery remain underexplored. Objective: To compare the outcomes of Jaboulay’s technique versus hydrocelectomy with sac excision using a vessel sealing device in adult patients with hydroceles. Methods: This randomized controlled trial was conducted at a tertiary care hospital. A total of 86 patients with idiopathic hydroceles were randomly allocated into two groups. Group A (n=43) underwent hydrocelectomy with sac excision using a vessel sealing device, while Group B (n=43) underwent Jaboulay’s procedure. Post-operative outcomes, including hematoma, edema, surgery duration, and hospital stay, were recorded over a 4-week follow-up period. Results: Among the 86 patients, 89.5% had unilateral and 10.5% had bilateral hydroceles. The mean age was 49.92 ± 6.78 years, with 66.3% over 45 years of age. Urban residents comprised 69.8% of the cohort, and 66.3% were from middle-income backgrounds. Group A had fewer cases of hematoma (2.3%) compared to Group B (7.0%), though the difference was not statistically significant (P=0.306). Edema was significantly lower in Group A (9.3%) compared to Group B (34.9%) (P=0.004). Surgery duration was comparable between the groups (P=0.674). Hospital stay was significantly shorter for Group A (1.51 ± 0.63 days) compared to Group B (1.88 ± 0.62 days) (P=0.007). Conclusion: Hydrocelectomy with sac excision using a vessel sealing device demonstrated superior outcomes compared to Jaboulay’s technique, with significantly fewer complications, particularly edema, and a shorter hospital stay. This method offers a safe and effective alternative for managing adult hydrocele patients.
Downloads
References
Persson J, Yan J, Angerås O, Venetsanos D, Jeppsson A, Sjögren I, et al. PCI or CABG for left main coronary artery disease: the SWEDEHEART registry. European Heart Journal. 2023;44(30):2833-2842.
Gallo M, Blitzer D, Laforgia PL, Doulamis IP, Perrin N, Bortolussi G, et al. Percutaneous coronary intervention versus coronary artery bypass graft for left main coronary artery disease: a meta-analysis. The Journal of thoracic and cardiovascular surgery. 2022;163(1):94-105. e115.
Zimmermann FM, Ding VY, Pijls NH, Piroth Z, van Straten AH, Szekely L, et al. Fractional flow reserve–guided PCI or coronary bypass surgery for 3-vessel coronary artery disease: 3-year follow-up of the FAME 3 trial. Circulation. 2023;148(12):950-958.
Mohr FW, Morice M-C, Kappetein AP, Feldman TE, Ståhle E, Colombo A, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. The lancet. 2013;381(9867):629-638.
Banning AP, Serruys P, De Maria GL, Ryan N, Walsh S, Gonzalo N, et al. Five-year outcomes after state-of-the-art percutaneous coronary revascularization in patients with de novo three-vessel disease: final results of the SYNTAX II study. European Heart Journal. 2022;43(13):1307-1316.
Gaudino M, Hameed I, Di Franco A, Naik A, Demetres M, Biondi-Zoccai G, et al. Comparison of SYNTAX score strata effects of percutaneous and surgical revascularization trials: a meta-analysis. The Journal of thoracic and cardiovascular surgery. 2023;165(4):1405-1413. e1413.
Masuda S, Serruys PW, Ninomiya K, Kageyama S, Nozomi K, Gao C, et al. Impact of left ventricular ejection fraction on 10-year mortality in the SYNTAX trial. Cardiovascular Revascularization Medicine. 2024;58:7-15.
Uygur B, Demir AR, Guner A, Iyigun T, Uzun N, Celik O. Utility of logistic clinical SYNTAX score in prediction of in‐hospital mortality in ST‐elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery. Journal of Cardiac Surgery. 2021;36(3):857-863.
Salimi A, Zolghadrasli A, Jahangiri S, Hatamnejad MR, Bazrafshan M, Izadpanah P, et al. The potential of HEART score to detect the severity of coronary artery disease according to SYNTAX score. Scientific Reports. 2023;13(1):7228.
Yoon JY, Lee JH, Kim HN, Kim N, Jang SY, Bae MH, et al. The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease. Frontiers in Cardiovascular Medicine. 2022;9:912286.
Xu M, Chen H, Li H-W. The association between SYNTAX score and long-term outcomes in patients with unstable angina pectoris: a single-centre retrospective study. BMC Cardiovascular Disorders. 2022;22(1):155.
Di Maio M, Esposito L, Silverio A, Bellino M, Cancro FP, De Luca G, et al. Prognostic significance of the SYNTAX score and SYNTAX score II in patients with myocardial infarction treated with percutaneous coronary intervention. Catheterization and Cardiovascular Interventions. 2023;102(5):779-787.
Satheesh S, Kumar R, Pillai AA, Selvaraj R, Nair S, Priya D. Prognostic values of SYNTAX score II in patients with coronary artery disease undergoing percutaneous coronary intervention–Cohort study. Indian heart journal. 2024;76(2):108-112.
Barac YD, Witberg G, Assali A, Klempfner R, Krutzwald-Josefson E, Rubchevsky V, et al. The Clinical SYNTAX score predicts survival better than the SYNTAX score in coronary revascularization. The Journal of Thoracic and Cardiovascular Surgery. 2024;167(1):164-173. e164.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 AK KHAN , FY PANNU , M AMIN , S MUQEET , S IQBAL , S MUNIR
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.