Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, NO. 321 Zhongshan Road, Gulou District, Nanjing, Jiangsu Province, China.
Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
Int J Colorectal Dis. 2024 Jul 31;39(1):120. doi: 10.1007/s00384-024-04691-y.
To explore the value of treatment choice and clinical prognosis for Riolan's arch in chronic superior mesenteric artery (SMA) ischaemic disease in vascular surgery.
The clinical data of 215 patients with SMA ischaemic disease (41 cases with Riolan's arch and 174 cases without) admitted to the Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University (China) from January 2019 to April 2023 were reviewed. Clinical characteristics, imaging findings, treatment, perioperative complications, and patient follow-up data were analysed to observe the impact of Riolan's arch on the prognosis of patients with SMA ischaemic disease.
There were significant differences in body mass index (Riolan's arch group: 22.82 ± 3.28 vs 24.03 ± 4.26 in non-Riolan's arch group, P = 0.049), Takayasu's arteritis (4.9% vs 0, respectively, P = 0.036), and secondary intervention (3.3% vs 1.9%, respectively, P < 0.001) between the two groups. Propensity score matching was used to exclude the effect of baseline data on patient outcomes. There were significant differences related to therapy method (conservative treatment, Riolan's arch group: 24.1% vs 39.7% in the non-Riolan's arch group; operative treatment, Riolan's arch group: 51.7% vs 20.7% in the non-Riolan's arch group, P = 0.014), as well as in-hospital time (9.79 ± 4.20 vs 6.86 ± 4.32, respectively, P = 0.011). There was no statistically significant difference in Kaplan-Meier curves between the two groups (log-rank test P = 0.476).
Riolan's arch plays an important compensatory role in SMA ischaemic disease, especially in chronic disease. We found significant differences in the treatment methods and length of hospital stay of Riolan's arch, which may suggest that Riolan's arch has some reference value in the choice of treatment mode.
探讨血管外科治疗慢性肠系膜上动脉（SMA）缺血性疾病中 Riolan 弓的治疗选择和临床预后的价值。
回顾性分析 2019 年 1 月至 2023 年 4 月期间南京鼓楼医院血管外科收治的 215 例 SMA 缺血性疾病患者（41 例 Riolan 弓患者和 174 例非 Riolan 弓患者）的临床资料。分析患者的临床特征、影像学表现、治疗方法、围手术期并发症及随访资料，观察 Riolan 弓对 SMA 缺血性疾病患者预后的影响。
两组患者的体质指数（Riolan 弓组：22.82±3.28 vs 非 Riolan 弓组：24.03±4.26，P=0.049）、大动脉炎（4.9% vs 0，P=0.036）和二次介入（3.3% vs 1.9%，P<0.001）差异有统计学意义。采用倾向性评分匹配排除基线数据对患者结局的影响。两组在治疗方法上（保守治疗，Riolan 弓组：24.1% vs 非 Riolan 弓组：39.7%；手术治疗，Riolan 弓组：51.7% vs 非 Riolan 弓组：20.7%，P=0.014）和住院时间（9.79±4.20 vs 6.86±4.32，P=0.011）方面差异有统计学意义。两组的 Kaplan-Meier 曲线无统计学差异（log-rank 检验 P=0.476）。
Riolan 弓在 SMA 缺血性疾病中发挥着重要的代偿作用，特别是在慢性疾病中。我们发现 Riolan 弓在治疗方法和住院时间方面存在显著差异，这可能表明 Riolan 弓在治疗模式的选择上具有一定的参考价值。
