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妊娠期行腹腔镜脾动脉瘤切除及血管重建术

Laparoscopic Resection of a Splenic Artery Aneurysm with Vascular Reconstruction During Pregnancy.

机构信息

Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.

General Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.

出版信息

Ann Vasc Surg. 2021 Apr;72:666.e7-666.e11. doi: 10.1016/j.avsg.2020.10.016. Epub 2020 Nov 21.

Abstract

Splenic artery aneurysms (SAA) are more frequent in women and have a high rupture risk during pregnancy, with catastrophic outcomes. It is advisable to treat these aneurysms in pregnant and fertile women, whatever their diameter, given their increased risk for rupture. There are several therapeutic approaches: endovascular surgery using coil embolization or stent graft coverage; laparoscopic or open surgical resection with arterial reconstruction and ligation followed by splenectomy when necessary. This paper aims to report the successful treatment of SAA in second-trimester pregnant women using a laparoscopic approach with aneurysm resection and arterial reconstruction. This is a unique report of a minimally invasive approach with arterial reconstruction in a pregnant woman, thus reducing the risk of spleen infarction and potentially avoiding splenectomy.

摘要

脾动脉瘤(SAA)在女性中更为常见,并且在怀孕期间破裂风险很高,可能会导致灾难性后果。鉴于其破裂风险增加,建议对妊娠和有生育能力的女性进行治疗,无论其直径大小。有几种治疗方法:使用线圈栓塞或支架移植物覆盖的血管内手术;腹腔镜或开放性手术切除,同时进行动脉重建和必要时的脾切除术。本文旨在报告使用腹腔镜方法成功治疗妊娠中期女性 SAA 的病例,该方法采用动脉瘤切除术和动脉重建。这是一例微创动脉重建治疗孕妇 SAA 的独特病例报告,从而降低了脾梗死的风险,并可能避免了脾切除术。

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