Bakoyiannis C, Psathas E, Tsekouras N, Kafeza M, Georgopoulos S, Bastounis E, Papalambros E
First Department of Surgery, National and Kapodistrian University of Athens Medical School, Laiko Hospital, Athens Greece.
Int Angiol. 2011 Aug;30(4):388-92.
Chronic mesenteric ischemic disease is an unusual cause of chronic abdominal pain. We present our experience from open surgical treatment of patients with this rare disease followed by a short review of the literature. During the period 2006-2008, three patients were referred to our department with clinical and radiological findings of chronic mesenteric ischemic disease. In all patients, at least 2 out of 3 splachnic vessels (celiac artery, superior and inferior mesenteric artery) were occluded, with severe stenosis of the third. Open surgical revasculation was performed in all patients, using autologous or synthetic (Dacron) bypass grafts. Graft patency was examined with triplex ultrasound studies at 3, 6 and 12 months postoperatively and/or follow up CT angiography. All patients had patent grafts during the follow up period and have regained their normal body weight. Immediate and late results, technical details and controversies in open surgical revasculation for chronic mesenteric ischemic disease are reviewed. In conclusion open surgical revasculation for chronic mesenteric ischemic disease is a technically challenging procedure with good results in patients younger than 70 years old , with long occlusions of the splachnic vessels and severe calcification of the vessel wall.
慢性肠系膜缺血性疾病是慢性腹痛的一种罕见病因。我们介绍了对患有这种罕见疾病的患者进行开放手术治疗的经验，并对相关文献进行了简要回顾。在2006年至2008年期间，有三名患者因慢性肠系膜缺血性疾病的临床和影像学表现被转诊至我科。所有患者的三支内脏血管（腹腔动脉、肠系膜上动脉和肠系膜下动脉）中至少有两支闭塞，第三支有严重狭窄。所有患者均接受了开放手术血运重建，使用自体或合成（涤纶）旁路移植物。术后3个月、6个月和12个月通过三维超声检查和/或随访CT血管造影检查移植物通畅情况。所有患者在随访期间移植物均通畅，体重也恢复正常。本文回顾了慢性肠系膜缺血性疾病开放手术血运重建的近期和远期结果、技术细节及争议。总之，对于慢性肠系膜缺血性疾病，开放手术血运重建是一项技术上具有挑战性的手术，对于年龄小于70岁、内脏血管存在长段闭塞且血管壁严重钙化的患者，效果良好。
