ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The Comparison of Peripheric Arterial Bypass Grafting in Diabetic and Nondiabetic Patients
Sadettin DERNEK, Bülent TÜNERİR, Cenk S. ATALAY, Yavuz BEŞOĞUL, Behçet SEVİN, Recep ASLAN, Tuğrul KURAL
Osmangazi Üniversitesi, Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı
The results the greft performance for the peripheral arterial occlusions between the diabetic (DM) and non-diabetic (NDM) patients are debetable. The results of total 74 DM and NDM cases who were performed arterial grafts between 1990 and 1997 at Osmangazi University Faculty of Medicine, Thorasic and Cardiovascular Surgery Department retrospectively.

60 of 74 cases (81.1%) were NDM and mean age was 59±12 years and 14 of 74 (18.9%) were DM and mean age was 57±10 years. In both groups there were 2 women. In DM group, there were 4 (28.5%) insulin- dependant and 10 (71.5%) non insulin-dependant patients. In NDM group, 69 grafts were performed of which 49 (71%) grafts were sentetic and 20 (29%) were saphenous vein grafts. In DM group, 17 grafts of which 14 (82.3%) sentetic and 3 (17.7%) saphenous vein grafts were performed. The postoperative NDM group hospitalization was 14.5±7.3 days in and 16.2±7.9 days in DM group. Although, the time seems to be longer in DM group, it was not statistically significant (p>0.05).

After a one-year follow up the primary patency rate in NDM group was 55% (n=33). 27 cases (45%) were reoperated because secondary patency was obtioned and in 15 not. In NDM group, total of primary and secondary patency rates was 75% (n=45). In DM group we obtained 64.2% primary patency rate (n=9). 5 patients were reoperated (36%) we obtained 2 secondary patency and in 3 we couldn't. The statistics for graft patency was not significant between the two groups (p>0.05). Four (6.6%) NDM and 2 DM (14.2%) patients had graft or insicional infection. In NDM group 10 of the 15 patients and in DM group, all of the 3 patients of whom we couldn't obtain secondary patency, had major or minor amputations.

Although the infection and the amputation rates were higher in DM group, it was not statistically significant (p>0.05). The mortality rates were 11.6% (n=7) and 7.1% (n=1) in NDM and DM groups respectively. The mortality reasons were cardiac, gastrointestinal, renal and neurologic.

As a result, we determined that DM didn' t have any significant negative effects on surgical morbidity, mortality and graft patency rates.

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