Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2806_Библиотеки_им_академика_М_И_Перельмана

Initial studies regarding QoL after LE open surgical bypass reviewed patients’ pre- and post­operative functional status. In 1996, Abou­Zamzam et al. reviewed functional status after infrainguinal bypasses [28]. Five hundred thir­teen patients in this patient underwent infraingui­nal bypass at a single center over 15years. All included patients had ischemic rest pain or tissue loss and over 90% of the patients reviewed had a distal bypass target below the level of the knee. Of those patients who ambulated with assist devices preoperatively, 97% were found to main­tain this level of function at 6months postopera­tively. Independent living status was assessed; of those patients living independently preopera­tively, 99% maintained their independence at 6 months after surgery. A similar review of patients with CLTI retrospectively looked at 334 patients who underwent 419 infrainguinal bypasses at two institutions over a 7-year period [29]. Sixty-two percent of these bypasses had a distal target located below the knee. Limb sal­vage was reported as 85% at 1year, with only a 6% drop over the course of the next 2years; how­ever, the authors emphasized that one-quarter of their patients had not achieved wound healing at 1year, nearly one-fth had lost ambulatory sta­tus, and 5% were no longer living independently. These studies clearly demonstrate the juxtaposi­tion of excellent provider-specic outcomes alongside poor/failing PROMs.