Kavanagh D O, Dowdall J F, Younis F, Sheehan S, Mehigan D, Barry M C
Dept of Vascular Surgery, St Vincent's University Hospital, Dublin.
Ir J Med Sci. 2006 Jan-Mar;175(1):40-4. doi: 10.1007/BF03168999.
Traditionally treatment of aorto-enteric fistulae involved placement of an extra-anatomic bypass and graft excision. This is associated with limb loss (10-40%) and high mortality (10-70%). More recently in situ revascularisation has been advocated.
To examine our experience with the changing management of aorto-enteric fistulae over a 22-year period.
Demographic, clinical, operative and pathological data were recorded retrospectively.
Twenty-one patients were included. Seven had primary fistulae. Six died prior to intervention. Five had an extra-anatomical bypass (60% mortality, 40% limb loss), four had in-situ revascularisation (25% mortality), four had a primary repair (25% mortality) and two had insertion of a tube graft (primary fistulae). The overall survival rate was 38%. The postoperative survival rate was 6o%.
Techniques for operative management continue to evolve. The current trend is towards a local surgical approach with prolonged and intensive postoperative antimicrobial therapy. In our experience this approach has yielded acceptable outcomes.
传统上，主动脉肠瘘的治疗包括进行解剖外旁路手术和切除移植物。这与肢体丧失（10%-40%）和高死亡率（10%-70%）相关。最近，有人主张进行原位血管重建。
探讨我们在22年期间对主动脉肠瘘治疗方法变化的经验。
回顾性记录人口统计学、临床、手术和病理数据。
纳入21例患者。7例为原发性瘘。6例在干预前死亡。5例行解剖外旁路手术（死亡率60%，肢体丧失率40%），4例行原位血管重建（死亡率25%），4例行一期修复（死亡率25%），2例行管状移植物植入术（原发性瘘）。总体生存率为38%。术后生存率为60%。
手术治疗技术不断发展。当前趋势是采用局部手术方法并进行延长和强化的术后抗菌治疗。根据我们的经验，这种方法产生了可接受的结果。
