Medisch Spectrum Twente, Enschede, The Netherlands.
J Vasc Surg. 2010 May;51(5):1309-16. doi: 10.1016/j.jvs.2009.12.064. Epub 2010 Mar 20.
Treatment of chronic splanchnic syndrome remains controversial. In the past 10 years, endovascular repair (ER) has replaced open repair (OR) to some extent. This evidence summary reviews the available evidence for ER or OR of chronic splanchnic syndrome.
A systematic literature search of MEDLINE database was performed to identify all studies that evaluated treatment of chronic splanchnic syndrome between 1988 and 2009.
The best available evidence consists of prospectively accumulated but retrospectively analyzed data with a high risk for confounding. Only a few of these studies incorporated functional tests to assess splanchnic ischemia before or after treatment. ER has the advantage of low short-term morbidity but the disadvantage of decreased long-term primary patency compared with OR. ER and OR have similar rates of secondary patency, although the reintervention rate after ER is higher.
ER appears to be preferential in the treatment of elderly patients and in patients with comorbidity, severe cachexia, or hostile abdomen. Long-term results after OR are excellent. OR can still be proposed as the preferred option for relatively young and fit patients.
慢性内脏综合征的治疗仍存在争议。在过去的 10 年中，血管内修复（ER）在一定程度上已经取代了开放修复（OR）。本证据总结回顾了用于慢性内脏综合征的 ER 或 OR 的现有证据。
对 MEDLINE 数据库进行了系统的文献检索，以确定所有在 1988 年至 2009 年间评估慢性内脏综合征治疗的研究。
最佳的现有证据包括前瞻性积累但具有高混杂风险的回顾性分析数据。只有少数这些研究在治疗前后采用了功能测试来评估内脏缺血。与 OR 相比，ER 具有较低的短期发病率的优势，但长期原发性通畅率较低的缺点。ER 和 OR 的继发性通畅率相似，尽管 ER 后的再干预率较高。
ER 似乎更适合治疗老年患者和合并症、严重恶病质或敌对腹部的患者。OR 的长期结果非常出色。OR 仍然可以作为相对年轻和健康的患者的首选方案。
