{
    "abstract": "Vascular bypass surgery in children differs significantly from adults. It is a rarely performed procedure in the setting of trauma and tumor surgery. Besides technical challenges to reconstruct the small and spastic vessels, another concern in bypass grafting is the adequate limb length growth over time. The primary aim of this study was to assess long-term outcome after pediatric bypass grafting, in a single academic center, focusing on potential effects on limb development. In this retrospective cohort analyses we included all pediatric patients undergoing vascular bypass grafting at our department between 2002 and 2017. All patients\u2009\u2264\u200918\u00a0years suffered a traumatic injury or underwent a tumor resection of the lower or upper limb. The youngest female patient was 0.4\u00a0years, the youngest male patient was 3.5\u00a0years. During the observation period, 33 pediatric patients underwent vascular repair, whereby 15 patients underwent bypass grafting. Median overall follow-up was 4.7\u00a0years (IQR\u2009\u00b1\u20099). 8 patients (53%) had a traumatic injury (traumatic surgery group) and 7 patients had a planned orthopedic tumor resection (orthopedic surgery group). In 13/15 (87%) a great saphenous vein (GSV) graft and in 2/15 (13%) a Gore-Tex graft was used for bypassing. Both Gore-Tex grafts showed complete occlusion 12 and 16\u00a0years after implantation. No patient died in the early postoperative phase (<\u200930\u00a0days), however 3/7 (43%) in the orthopedic group died during follow-up. Revision surgery had to be performed in 1/15 (7%) patients. A functional use of the extremity was reported in all patients. Normal limb length growth according to the contralateral site, and therefore bypass growth, could be documented in 14/15 patients. Children are surgically challenging. In our study, surgery by a specialized vascular surgery team using GSV grafts led to adequate limb length and bypass growth, and we observed no functional restrictions.",
    "authors": [
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria.",
            "firstname": "Stephanie",
            "initials": "S",
            "lastname": "Kampf"
        },
        {
            "affiliation": "Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, Vienna, Austria.",
            "firstname": "Madeleine",
            "initials": "M",
            "lastname": "Willegger"
        },
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria.",
            "firstname": "Christopher",
            "initials": "C",
            "lastname": "Dawoud"
        },
        {
            "affiliation": "Austrian Public Health Institute, Gesundheit \u00d6sterreich GmbH, Vienna, Austria.",
            "firstname": "Gerhard",
            "initials": "G",
            "lastname": "F\u00fcl\u00f6p"
        },
        {
            "affiliation": "Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.",
            "firstname": "Philipp",
            "initials": "P",
            "lastname": "Lirk"
        },
        {
            "affiliation": "Division of Angiology, Department of Internal Medicine, Medical University of Vienna, Vienna, Austria.",
            "firstname": "Andrea",
            "initials": "A",
            "lastname": "Willfort-Ehringer"
        },
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria.",
            "firstname": "Christoph",
            "initials": "C",
            "lastname": "Neumayer"
        },
        {
            "affiliation": "Division of Vascular Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria. bernd.gollackner@meduniwien.ac.at.",
            "firstname": "Bernd",
            "initials": "B",
            "lastname": "Gollackner"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2021. The Author(s).",
    "doi": "10.1038/s41598-021-94971-2\n10.1016/j.jpedsurg.2009.09.017\n10.1016/j.jpedsurg.2006.09.016\n10.1016/j.jvs.2014.02.054\n10.1016/j.ejvs.2011.06.028\n10.1097/00005373-197908000-00001\n10.1177/000331977602700101\n10.1186/1749-799X-5-25\n10.1016/j.rbo.2016.08.016\n10.1016/j.jvs.2006.07.033\n10.1002/jso.20679\n10.1097/SLA.0000000000001455\n10.1067/mva.2001.115600\n10.1016/j.jvs.2018.07.029\n10.1016/j.ejvs.2006.06.009\n10.1097/TA.0000000000000225\n10.1097/TA.0000000000000812\n10.1016/0741-5214(86)90073-X\n10.1067/mva.2000.103792\n10.1177/1531003511408439\n10.1007/s00383-006-1778-5\n10.1097/00005373-197907000-00009\n10.1001/archsurg.1976.01360290103016\n10.1097/SCS.0b013e31824e7140\n10.1016/0741-5214(92)90378-L\n10.1016/j.jpedsurg.2016.07.001\n10.3109/03014460.2013.776110",
    "journal": "Scientific reports",
    "keywords": [],
    "methods": null,
    "publication_date": "2021-08-13",
    "pubmed_id": "34381065\n20638516\n21610390\n17208561\n24801554\n21820336\n469966\n1053458\n28530775\n20398337\n29234656\n17098540\n17458861\n26366542\n11436072\n30292605\n16872850\n24854305\n26402529\n3510323\n10709053\n8173726\n21810814\n17004094\n458896\n985076\n22777466\n7245048\n1522647\n25695213\n27497495\n23590681",
    "results": null,
    "title": "Long-term outcome in pediatric surgical bypass grafting after traumatic injury and tumor resection: retrospective cohort analysis.",
    "xml": "<Element 'PubmedArticle' at 0x78850625be70>"
}