Belczak Sergio Quilici, Lanziotti Luiz, Botelho Yuri, Aun Ricardo, Silva Erasmo Simão da, Puech-Leão Pedro, Luccia Nelson de
Vascular Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2014 Sep;69(9):641-6. doi: 10.6061/clinics/2014(09)11.
This systematic review focuses on the 30-day mortality associated with open surgery and fenestrated endografts for short-necked (<15 mm) juxtarenal abdominal aortic aneurysms. A search for studies published in English and indexed in the PubMed and Medline electronic databases from 2002 to 2012 was performed, using "juxtarenal abdominal aortic aneurysm" and "treatment" as the main keywords. Among the 110 potentially relevant studies that were initially identified, eight were in accordance with the inclusion criteria in the analysis. Similar outcomes for open and endovascular repair were observed for 30-day mortality. No differences were observed regarding the secondary outcomes (duration of surgery, hospital stay, postoperative renal dysfunction and late mortality), except that the late mortality rate was significantly higher for the patients treated with open repair after a median follow-up of 24 months. Fenestrated endografting is a viable alternative to conventional surgery in juxtarenal abdominal aortic aneurysms with a proximal neck <15 mm.
本系统评价聚焦于开放性手术和开窗型腔内移植物治疗短颈（<15mm）近肾腹主动脉瘤的30天死亡率。检索了2002年至2012年发表并被PubMed和Medline电子数据库收录的英文研究，以“近肾腹主动脉瘤”和“治疗”作为主要关键词。在最初识别出的110项潜在相关研究中，有8项符合纳入分析的标准。开放性手术和血管腔内修复术的30天死亡率观察结果相似。除了在中位随访24个月后接受开放性修复治疗的患者晚期死亡率显著更高外，在次要结局（手术持续时间、住院时间、术后肾功能障碍和晚期死亡率）方面未观察到差异。对于近端颈<15mm的近肾腹主动脉瘤，开窗型腔内移植物是传统手术的一种可行替代方案。
