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主动脉弓动脉瘤的治疗:开放手术还是杂交手术?

Treatment of aortic arch aneurysms: Open surgery or hybrid procedure?

作者信息

Gökalp Orhan, Yılık Levent, İner Hasan, Beşir Yüksel, Karakaş Yeşilkaya Nihan, Ergüneş Kazım, Lafcı Banu, Gürbüz Ali

机构信息

Department of Cardiovascular Surgery, Medicine Faculty of Katip Çelebi University, İzmir, Turkey.

Department of Cardiovascular Surgery, Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jul 3;26(3):351-358. doi: 10.5606/tgkdc.dergisi.2018.15391. eCollection 2018 Jul.

Abstract

BACKGROUND

This study aims to compare the results of hybrid procedure and open surgery for the treatment of aortic arch aneurysms.

METHODS

Twenty-six p atients (21 m ales, 5 females; m ean a ge 56.6±12.4 years; range, 20 to 83 years) who underwent total aortic arch replacement for aortic arch aneurysm between January 2004 and January 2010 were retrospectively analyzed. The patients were divided into two groups: open conventional surgery group (group 1, n=15) and hybrid procedure (total debranching of the aortic arch and simultaneous endovascular stent) group (group 2, n=11). Survival rates and need for reoperation were compared between the groups.

RESULTS

The hybrid procedure was found to be more favorable in terms of postoperative revision, extubation period, and drainage amounts. However, there was no statistically significant difference in the survival rates, need for reoperation, and major adverse cardiovascular events between the groups.

CONCLUSION

Our study results suggest that conventional open surgery and hybrid procedure are similar in terms of survival and short-to-mid-term results in patients undergoing total aortic arch replacement for aortic arch aneurysm.

摘要

背景

本研究旨在比较杂交手术与开放手术治疗主动脉弓动脉瘤的效果。

方法

回顾性分析2004年1月至2010年1月期间因主动脉弓动脉瘤接受全主动脉弓置换术的26例患者(21例男性,5例女性;平均年龄56.6±12.4岁;范围20至83岁)。患者分为两组:开放传统手术组(第1组,n = 15)和杂交手术组(主动脉弓完全去分支并同时行血管内支架置入术,第2组,n = 11)。比较两组的生存率和再次手术需求。

结果

杂交手术在术后翻修、拔管时间和引流量方面更具优势。然而,两组在生存率、再次手术需求和主要不良心血管事件方面无统计学显著差异。

结论

我们的研究结果表明,对于因主动脉弓动脉瘤接受全主动脉弓置换术的患者,传统开放手术和杂交手术在生存率及短期至中期结果方面相似。

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