Efficacy of Preoperative Color Doppler Sonography of Lower Extremity Veins on Postoperative Outcomes in Candidates of Saphenectomy: A Randomized Clinical Trial

Abstract

BackgroundDoppler sonography is a type of sonography used for imaging the blood flow in the vessels and heart. This technique uses ultrasound waves with high frequency. In some patient candidates for venous graft, the identification of the suitable vein is not possible with clinical examination.ObjectiveThis study compared the effects of preoperative color Doppler sonography of lower extremity veins on the postoperative outcomes of saphenectomy.MethodsThis randomized clinical trial was conducted on 100 candidates of an off-pump coronary artery bypass graft (CABG) hospitalized in Afshar Hospital in Yazd in 2015. Patients were divided into two groups: 50 patients in the study group and 50 patients in the control group. Patients in the study group underwent color Doppler sonography of lower extremity veins using the Medison 8000 Live device. Patients in the control group were assessed preoperatively by routine venous examination without undergoing color Doppler sonography. The prepping and draping methods and also the preoperative antibiotics were the same for both groups. The patients were assessed for wound infection, edema, hematoma, and DVT 2 days, 1 week, and 1 month after surgery. Data were analyzed by SPSS version 16 using t-test, Chi-square, and Fisher’s exact test.ResultsThe length of incision for saphenectomy was 29.20 ± 3.71 cm in the Doppler group and 28.98 ± 3.72 cm in the non-Doppler group with no significant difference between the two groups (p=0.768). The two groups were not significantly different with respect to age, gender, diabetes, hypertension, hyperlipidemia, smoking, and history of peripheral vessels disease, postoperative infection, postoperative organ edema, postoperative hematoma, and postoperative DVT.ConclusionPreoperative color Doppler sonography of the saphenous vein before saphenectomy has no effect on reducing the postoperative complications, and saphenectomy on the basis of intraoperative examination of the vein course by the surgeon has acceptable consequences.Clinical trial registrationThe trial was registered at the Thai Clinical Trials Registry (TCTR) (http://www.clinicaltrials.in.th) with the TCTR ID: TCTR20160708001.FundingThe authors received no financial support for the research, authorship, and/or publication of this article.

Effect of preoperative ultrasound mapping of the saphenous vein on leg wound complications after coronary artery bypass surgery: a systematic review

“…The possible risk of bias was assessed using either the Cochrane Risk of Bias Assessment [18] or the ROB-INS-I tool [19] for the RCTs [20,21] and non-RCTs [6,12,22], as appropriate (Table 1). Both risk of bias assessment tools include several domains whereby in which regard each study is evaluated independently.…”

“…Of 4514 papers screened in this systematic review, 36 papers underwent full-text assessment with final inclusion of five studies [6,12,[20][21][22] (Fig. 1).…”

“…1). Of the five included studies, two were RCTs [20,21] and three were cohort studies [6,12,22], respectively. Studies were mainly excluded as the outcomes of interest were not reported.…”

“…The Oxford Centre for Evidence Based Medicine tool was used to classify the quality of included studies [23]. Only one of the included studies used concealed allocation [21]. One of the randomized studies [20] did not provide information regarding the randomization protocol.…”

Comparison of clear effect and the complications, and short and mid-term effects between ultrasound-guided and non-guided catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity

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