Uticaj tri različite hirurške tehnike na histološke i imunohistohemijske karakteristike venskih graftova
Doktorand
Živković, IgorMentor
Milić, DraganČlanovi komisije
Mićović, SlobodanPutnik, Svetozar
Krstić, Miljan
Velinović, Miloš
Metapodaci
Prikaz svih podataka o disertacijiSažetak
Background and Objectives: The saphenous vein is one of the most common
used grafts (SVG) for surgical revascularisation. The mechanism of the SVGs
occlusion is still unknown. Surgical preparation techniques have an important
role in the early and late graft occlusion. Our study analyzed the influence of
the three different surgical techniques on the histological and
immunohistochemical characteristics of the vein grafts harvested by three
different techniques.
Methods: Between Jun 2019 and December 2020, 83 patients who underwent
surgical revascularization were prospectively randomly assigned into three
groups according to saphenous vein graft harvesting (conventional (CVH), notouch
(NT) and endoscopic (EVH)) technique. The vein graft samples were sent
on the histological (hematoxylin-eosin staining) and immunohistochemical
(CD31, Factor VIII, Caveolin and eNOS) examinations.
Results: the CVH, NT, and EVH groups included 27 patients (mean age
67.66±5.6), 31 patients (mean age 66.5±7.4...) and 25 patients (mean age 66±5.5),
respectively. Hematoxylin-eosin staining revealed a lower grade of
microstructural vein damage in the NT group (2, IQR 1-2) in comparison with
CVH and EVH (3, IQR 2-4), (4, IQR 2-4) respectively (p <0.001).
Immunohistochemical examination revealed a high grade of staining in the NT
group compared to the CVH and EVH group (CD 31 antibody p=0.02,
FVIII, p<0.001, Caveolin, p=0.001, and eNOS, p=0.003).
The best preservation of the structural vein integrity was in the NT group, while
the lowest rate of leg wound complication was in the EVH group. Those facts
increase the interest in developing and implementing the endoscopic no-touch
technique.