This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Treatment of the hostile groin: 5‐year follow‐up of the obturator foramen bypass. BJS 2001; 88: 619-619.
Published: 6th December 2002
Authors: J. Coker, M. S. Sobeh, M. Grahn, E. J. Chaloner, R. J. Ham
Background
Infection in the groin threatens both life and limb. In recent times virulent organisms, especially methicillin‐resistant staphylococci, have proved difficult to treat. The obturator foramen bypass, although performed infrequently, represents an extra‐anatomical solution to the ‘hostile groin’. The aim of the study was to examine the primary and secondary graft patency rates in 26 patients (28 procedures) performed in one hospital over 10 years.
Method
There were 17 men and nine women with mean age of 65 (range 49–78) years. All procedures except one were performed with expanded polytetrafluoroethylene (6 mm in 24 patients; 8 mm in three). Twenty‐one patients had critical ischaemia with rest pain or tissue loss. The inflow vessel was the common iliac artery in 25 patients and the lower abdominal aorta in three. The distal anastomosis was to the profunda in two grafts, to the suprageniculate popliteal artery in 24 grafts and to the infrageniculate popliteal in two.
Results
Patency rates were calculated with the Kaplan–Meier life‐table method.
Conclusion
The obturator foramen bypass, although technically demanding, is a viable solution in the individual with groin sepsis and ischaemia. Frequently these patients have good calibre vessels above and below the problem groin. © 2001 British Journal of Surgery Society Ltd
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