IMPACT FOR FUTURE RESEARCH
Though comparing the techniques and outcomes associated with Z-2-FET and
Z-0-FET is vital to assess the extent to which proximalisation of arch
repair represents therapeutic advancement, it should be stressed that
the comparisons made herein are limited in a number of aspects. Perhaps
most significantly is the fact that, relative to Z-2-FET and even
Z-3-FET, Z-0-FET arch repair procedures are far more novel and are
reported far less in literature. As a result, conducting statistical
comparisons between the different procedures, perhaps via a
meta-analysis of clinical outcomes, would be extremely challenging. Much
of the literature on FET arch repairs are limited in value due to their
notably small sample size and are largely retrospective cohort studies
or individual case reports.16-18 Furthermore, FET arch
repair procedures are particularly complex and exact surgical technique
necessarily varies from patient-to-patient due to variations in anatomy,
presentation, and disease progression.5 This
represents an additional limitation to direct, retrospective,
smaller-scale comparisons between Z-2-FET and Z-0-FET approaches. Larger
scale, multi-centre, cohort studies or randomised trials including
long-term follow up and monitoring would serve to elucidate better the
true extent to which proximalisation of arch repair improves clinical
outcomes.