The value of obturator canal bypass. A review
T. Sautner, B. Niederle, F. Herbst, G. Kretschmer, P. Polterauer, K. H. Rendl and K. Prenner
Department of Surgery, University of Vienna Medical School, Austria.
OBJECTIVE: To review the value of obturator canal bypass with respect to
long-term results. DESIGN: Case series and literature review. SETTING:
University of Vienna Medical School in Austria. PATIENTS/METHODS: Personal
experience with 34 consecutive patients and 125 cases published since 1982
with respect to patient data, patency, and survival are compared and
jointly analyzed retrospectively. INTERVENTIONS: Patients received
obturator canal bypass for lesions of the pelvic or common femoral vessels
precluding orthotopic reconstruction. MAIN OUTCOME MEASURES: The rates of
patient survival, limb salvage, and graft patency were analyzed. RESULTS:
The postoperative mortality rate in the present series was 14.7%. The limb
salvage rate after 5 years was 76.5%. One- and 5-year secondary patency
rates were 75.3% and 54.9%, respectively. All grafts in patients without
atherosclerosis were patent at a median of 34 months. For 57 cases
documented in the literature, 1- and 5-year patency rates were 70.8% and
59.7%, respectively. Combined analysis of 90 obturator canal bypasses
revealed rates of 72.7% and 56.9% of patent grafts at 1- and 5-years,
respectively. CONCLUSIONS: The use of obturator canal bypass is recommended
in deep groin infections and especially in patients with lesions of the
pelvic vessels due to other occlusive vascular disease.
