End-to-end versus end-to-side microvascular anastomosis: a meta-analysis of free flap outcomes

Ahmadi, Iraj, Herle, Pradyumna, Miller, George, Hunter-smith, David J., Leong, James, and Rozen, Warren Matthew (2017) End-to-end versus end-to-side microvascular anastomosis: a meta-analysis of free flap outcomes. Journal of Reconstructive Microsurgery, 33 (6). pp. 402-411.

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Abstract

Background: Optimal outcomes in microsurgery have been attributed to a range of factors, with performing of end-to-end (ETE) versus end-to-side (ETS) influencing anastomotic complications and flap outcomes.

Methods: A systematic review of the literature and meta-an alysis was undertaken to evaluate the relative risks of anastomotic complications with ETE versus ETS approaches, for arterial and venous anastomoses looking at risk ratios (RRs) for thrombosis and overall flap failure.

Results: RRs of thrombosis and flap failure in ETS versus ETE venous anastomosis groups were 1.30 (95% confidence interval [CI]: 0.53-3.21) and 1.50 (95% CI: 0.85-2.67), respectively. The RRs of thrombosis and flap failure in ETS versus ETE arterial anastomosis groups were 1.04 (95% CI: 0.32-3.35) and 1.04 (95% CI: 0.72-1.48), respectively.

Conclusion: Differences in rates of thrombosis and flap failure between ETE and ETS venous and arterial anastomoses are marginal and nonsignificant. As such, the type of anastomotic technique is best decided on a case-by-case basis, dependent on anatomical, surgical, and patient factors.

Item ID: 53983
Item Type: Article (Research - C1)
ISSN: 1098-8947
Keywords: anastomosis; arterial; artery; free flap; microsurgery; venous
Date Deposited: 13 Jun 2018 04:00
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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