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吻合口动脉瘤——来自一个中心的20年经验

Anastomotic aneurysms--20-years of experience from one center.

作者信息

Pogorzelski Ryszard, Fiszer Patryk, Toutounchi Sadegh, Krajewska Ewa, Szostek Małgorzata M, Tworus Robert, Jakuczun Wawrzyniec, Skórski Maciej

出版信息

Pol Przegl Chir. 2013 Apr;85(4):181-91. doi: 10.2478/pjs-2013-0028.

Abstract

UNLABELLED

Anastomotic aneurysms may develop after any type of vascular surgery, in different areas of the arterial system, and require reoperation. The frequency of occurrence of the above-mentioned is estimated at 1-5%.

MATERIAL AND METHODS

During the period between 1989 and 2010, 180 patients with 230 anastomotic aneurysms were subject to surgical intervention at the Department of General and Thoracic Surgery, Warsaw Medical University. The study group comprised 21 (11.7%) female and 159 (88.3%) male patients, aged between 30 and 87 years (mean age - 62.8 years). In relation to the number of anastomoses aneurysms were diagnosed in 2.1% of cases. Twenty-four (10.4%) patients were diagnosed with recurrent aneurysms.

RESULTS

Surgical procedures performed were as follows: artificial prosthesis implantation (119), reanastomosis (40), patch plasty (25), graftectomy (19), prosthesis replacement (9), and stent-graft (7) implantation. 195 (84.8%) aneurysms were subject to planned surgery, while 35 (15.2%) required emergency intervention. 77.8% of patients were diagnosed with aseptic aneurysms, while the remaining 22.2% with infected perioperative aneurysms. Good treatment results were obtained in 149 (82.8%) patients. Limb amputations were performed in 19 (10.5%) cases. Twelve (6.7%) patients died as a consequence of infection and general complications.

CONCLUSIONS

Vascular reoperations are a difficult clinical problem and are burdened with a high rate of complications. The above-mentioned often require complex treatment, in order to improve therapeutic results.

摘要

未标注

吻合口动脉瘤可在任何类型的血管手术后,于动脉系统的不同部位发生,且需要再次手术。上述情况的发生率估计为1% - 5%。

材料与方法

在1989年至2010年期间,华沙医科大学普通胸外科对180例患有230个吻合口动脉瘤的患者进行了手术干预。研究组包括21名(11.7%)女性和159名(88.3%)男性患者,年龄在30至87岁之间(平均年龄 - 62.8岁)。就吻合口数量而言,动脉瘤在2.1%的病例中被诊断出来。24名(10.4%)患者被诊断为复发性动脉瘤。

结果

所进行的外科手术如下:人工假体植入(119例)、再次吻合(40例)、补片成形术(25例)、移植物切除术(19例)、假体置换(9例)以及支架移植物植入(7例)。195个(84.8%)动脉瘤接受了计划性手术,而35个(15.2%)需要紧急干预。77.8%的患者被诊断为无菌性动脉瘤,其余22.2%为感染性围手术期动脉瘤。149名(82.8%)患者获得了良好的治疗效果。19例(10.5%)进行了肢体截肢。12名(6.7%)患者因感染和全身并发症死亡。

结论

血管再次手术是一个棘手的临床问题,并发症发生率很高。上述情况通常需要复杂的治疗,以提高治疗效果。

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