{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:14:10Z","timestamp":1760202850600},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An increased operative time (OT) has been associated with a higher rate of adverse outcomes after several surgical procedures although scarce evidence exists for infrainguinal bypass surgery (IBS) and its impact beyond the postoperative period. The aim of this study was to define surgical characteristics related to a prolonged OT in IBS for chronic limb threatening ischemia and its influence on postoperative and 1\u2010year outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Retrospective study of 249 consecutive patients (mean age 72.4 years, 73.1% male) undergoing IBS for CLI between 2008 and 2018. The characteristics related to the duration of surgery and its impact on outcome were assessed with a multiple linear regression and a multivariate logistic regression, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Interventions associated with a prolonged OT included the bypass to a below\u2010the\u2010knee artery (additional 36\u00a0min, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), the need for an alternative vein or a hybrid PTFE\u2010vein graft (additional 37\u00a0min, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and inflow associated procedures (additional 47\u00a0min, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). OT was associated with a higher rate of postoperative complications (OR for each additional 30\u00a0min 1.123, 95% CI 1.021\u20131.234) and need for a sociosanitary facility at discharge (OR 1.143, 95% CI 1.033\u20131.265). At 1\u2010year of follow\u2010up, OT was related to a higher major amputation rate (OR 1.201, 95% CI 1.036\u20131.393) and non\u2010significantly to mortality (OR 1.125, 95% CI 0.999\u20131.268).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A prolonged OT is a risk factor for adverse outcomes after IBS that extends beyond the immediate postoperative period. Further research is needed to evaluate how an expected high OT might influence decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05726-5","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T16:07:29Z","timestamp":1597162049000},"page":"4261-4266","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Influence of Operative Time in the Results of Infrainguinal Bypass for Chronic Limb Threatening Ischemia"],"prefix":"10.1002","volume":"44","author":[{"given":"Cristina","family":"Almorza","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery Hospital del Mar Paseo Mar\u00edtimo 25\u201029 08003 Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Marcos","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Hospital del Mar Paseo Mar\u00edtimo 25\u201029 08003 Barcelona 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Mar\u00edtimo 25\u201029 08003 Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Clara","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Hospital del Mar Paseo Mar\u00edtimo 25\u201029 08003 Barcelona Spain"},{"name":"Universitat Aut\u00f3noma de Barcelona Barcelona Spain"},{"name":"CIBER Cardiovascular Barcelona 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