Effect of Pleurotomy on Blood Loss During Coronary Artery Bypass Grafting

Atay, Yüksel; Yağdı, Tahir; Engin, Çağatay; Ayik, Fatih; Oğuz, Enis; Alayunt, Alp; Özbaran, Mustafa; Durmaz, İsa

doi:10.1111/j.1540-8191.2008.00715.x

Cited by 9 publications

(13 citation statements)

References 17 publications

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“…Ozkara et al and Atay et al also reported a significant decrease in the duration of mechanical ventilation in the closed pleura group. 16,17 Our current study have showed no significant difference in post-operative pain between the two groups 4 (3.75 to 5) vs. 4.5 (4 to 6), p value=0.28).Postoperative pain results from a study by Sanad et al had shown a statistical significance difference in the median score between both groups (p=0.007). 15 Similarly Gullu et al and Oz et al have reported the pain to be higher among the open pleura group.…”

Section: Rolla Et Al and Lim Et Al Have Also Reported Statistically Significant Incidence Of Pleuropulmonary Complicationscontrasting

confidence: 42%

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Does pleurotomy for internal mammary artery harvest increase postoperative complications? A comparative study of internal mammary artery harvest with and without pleurotomy

Palanki¹,

Kummari²,

Dontineni³

et al. 2021

Int J Res Med Sci

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Background: To assess and compare the postoperative complications in patients who are undergoing Left Internal Mammary artery harvesting for coronary artery bypass grafting surgery with pleurotomy and without pleurotomy.Methods: The study was conducted on the patients admitted in a single unit of department of cardiothoracic surgery,NIMS, Hyderabad during the period of July 2017 to December2017.The study was a randomized open labelled controlled trial of two interventions.A total of 90 patients undergoing Coronary artery bypass surgery were enrolled in the study,with 60 among them having their Internal mammary harvesting done with pleurotomy and 30 undergoing the same without pleurotomy.Results: In the non pleurotomy group, 16 (53.33%) were male and 14 (46.66%) were female.In the pleurotmy group males and females were 41 (68.33%) and 19 (31.66%) respectively.There was no statistical significance between both the groups with respect to posteroperative bleeding, icu stay, reexploration rate,duration of ventilation,PaO2 and PCo2 values or wound infection rates. The only difference between both the groups which showed statistical significance(0.051) was the occurence of pleural effusion on POD 5 .In the closed pleurotomy group only 2(6.66%) patients had pleural effusion upto POD5, whereas in the open pleurotomy group 14 (23.33%) patients had pleural effusion persisting till POD5.Conclusions: There is a higher incidence of Pleural effusion in the pleurotomy group although this did not translate into higher postop pain score,ICU/Hospital stay, wound infection rates.

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Section: Rolla Et Al and Lim Et Al Have Also Reported Statistically Significant Incidence Of Pleuropulmonary Complicationscontrasting

confidence: 42%

“…15 The results by Ozkara et al and Atay et al also differed from our study. 16,17 These studies sowed lesser duration of mechanical ventilation.…”

Section: Rolla Et Al and Lim Et Al Have Also Reported Statistically Significant Incidence Of Pleuropulmonary Complicationsmentioning

confidence: 98%

Does pleurotomy for internal mammary artery harvest increase postoperative complications? A comparative study of internal mammary artery harvest with and without pleurotomy

Palanki¹,

Kummari²,

Dontineni³

et al. 2021

Int J Res Med Sci

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“…There may be considerations that better perfusion of LIMA bed could enhance postoperative drainage. Atay et al [ 5 ] suggested that preserved pleural integrity reduces postoperative blood loss independent of LIMA harvesting technique. Göksin et al [ 17 ] dichotomized the patients that underwent pedicled internal mammary artery harvesting according to whether pleural integrity had been preserved or not.…”

Section: Discussionmentioning

confidence: 99%

Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG

Özülkü¹,

Aygün²

2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveWe investigated the effects of pedicled and semiskeletonized left internal mammary artery (LIMA) harvesting techniques on postoperative drainage in patients subjected to off-pump CABG, ignoring other advantages or disadvantages of those techniques.MethodsThe present study comprises a total of 160 subjects that underwent coronary artery bypass surgery in our clinic. Data were collected consecutively and retrospectively. An attempt was made to have similar groups in terms of demographic characteristics. Patients that underwent off-pump coronary artery bypass surgery by two surgical teams which differed only in LIMA harvesting technique were dichotomized and compared according to these techniques. The first group (Group 1) consisted of patients in whom LIMA was harvested with surrounding tissues using the pedicled technique. The second group (Group 2) consisted of patients in whom LIMA was harvested using the semiskeletonized technique, with the veins separated from surrounding connective tissues.ResultsThe mean amount of drainage in the first 24 hours was 706.1±234.2 ml vs. 591±258.8 ml (Group 1 vs. Group 2; P=0.005), the mean amount of drainage in the second 24 hours was 270±133.6 ml vs. 189.4±140.4 ml (Group 1 vs. Group 2; P<0.001), and the mean amount of total drainage was determined to be 976.1±306.9 ml vs. 781.2±335.5 ml (Group 1 vs. Group 2; P<0.001).ConclusionIt was observed that semiskeletonized LIMA presents reduced amount of postoperative drainage in the first and second 24-hour periods and total amount of drainage than pedicled LIMA, independent of pleural integrity.

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“…Rolla et al [ 21 ] emphasized that there was no increase in the incidence of atelectasis or pleural effusion between the 2 nd and 5 th postoperative day with opening the pleura in the patients who underwent LIMA harvesting. Lim et al [ 22 ] , Atay et al [ 23 ] , and Oz et al [ 16 ] stated that atelectasis and pleural effusion are significantly more prevalent in the patients, in whom pleura was opened intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

Effect of postoperative pleural effusion in patients undergoing on-pump CABG

Özülkü¹,

Aygün²

2015

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveThe present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting.MethodsA total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11.ResultsThe incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump) as compared to Group 2 (off-pump). But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893), P>0.05 for bilateral pleural effusion (P=0.780)]. Left pleural effusion was encountered to be lower in Group 2 (off-pump). The difference was found to be statistically significant (P<0.05, P=0.006).ConclusionUnder the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

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Effect of Pleurotomy on Blood Loss During Coronary Artery Bypass Grafting

Cited by 9 publications

References 17 publications

Does pleurotomy for internal mammary artery harvest increase postoperative complications? A comparative study of internal mammary artery harvest with and without pleurotomy

Does pleurotomy for internal mammary artery harvest increase postoperative complications? A comparative study of internal mammary artery harvest with and without pleurotomy

Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG

Effect of postoperative pleural effusion in patients undergoing on-pump CABG

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