Kim J Y, Kim D I, Do Y S, Lee B B, Kim Y W, Shin S W, Byun H S, Roh H G, Choo I W, Hyon W S, Shim J S, Choi J Y
Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Eur J Vasc Endovasc Surg. 2006 Jul;32(1):101-6. doi: 10.1016/j.ejvs.2006.01.004. Epub 2006 Feb 14.
We report our 10 years experience of the surgical treatment of congenital arteriovenous malformation (AVM).
We retrospectively reviewed the medical records of 145 patients with AVM who visited Samsung Medical Center in Korea from 1994 to 2003. Among the 145 patients, 21 patients were operated on. Preoperative embolo/sclerotherapy was done in 20 out of the 21 patients.
The surgically treated AVMs were 13 cases of head and neck lesions, four cases of upper extremity lesions, one case each of back lesion, uterus lesion, lower extremity lesion and multiple site lesions. There were 10 patients with the extratruncular infiltrating type, nine patients with the extratruncular limited type, one patient with a truncular superficial AV fistula and one patient with a mixed type. Fourteen cases were operated on for cosmetic reasons and since they had localized lesions, and five cases were operated on for tissue necrosis. Fourteen cases were cured by a single operation, yet seven cases needed several sessions of operation to cure the AVM or to promote wound healing after surgery.
The surgical treatment of AVM is a challenging issue for vascular surgeons. To minimise the complications related to surgery, a multidisciplinary team approach should be considered.
我们报告先天性动静脉畸形（AVM）手术治疗的10年经验。
我们回顾性分析了1994年至2003年期间就诊于韩国三星医疗中心的145例AVM患者的病历。在这145例患者中，21例接受了手术治疗。21例患者中有20例在术前进行了栓塞/硬化治疗。
接受手术治疗的AVM中，头颈部病变13例，上肢病变4例，背部病变、子宫病变、下肢病变及多部位病变各1例。有10例为血管外浸润型，9例为血管外局限型，1例为血管主干浅表动静脉瘘，1例为混合型。14例因美容原因且病变局限而接受手术，5例因组织坏死接受手术。14例经一次手术治愈，但7例需要多次手术来治愈AVM或促进术后伤口愈合。
AVM的手术治疗对血管外科医生来说是一个具有挑战性的问题。为了尽量减少与手术相关的并发症，应考虑采用多学科团队方法。
