Harmantepe Ahmet Tarik, Dikicier Enis, Dulger Ugur Can, Kucuk Furkan, Gonullu Emre, Demir Hakan, Erkorkmaz Unal
Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkiye.
Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkiye.
North Clin Istanb. 2025 Apr 28;12(2):162-172. doi: 10.14744/nci.2023.82231. eCollection 2025.
It was aimed to compare the prognostic risk factors and multidisciplinary treatments affecting mortality in acute mesenteric ischemia (AMI).
We retrospectively analyzed 111 patients treated for acute mesenteric ischemia between January 2012 and January 2023. Patients were divided into 2 groups as alive and dead for early survey (postoperative 28 days). The characteristics of the two groups were compared and the factors affecting early mortality were investigated. Factors affecting the presence of perioperative ischemia, the length of ischemia, the length of the resected bowel, and the length of the remaining small bowel from the ligament of Treitz were investigated. The results of different treatment processes were analyzed.
The mean age was 71.67, years with 64 (57.6%) males and 47 (42.3%) females. Early mortality rate was 47.7%. Envas was applied to 9 (8.1%) patients. EnvasSurg to 19 (17.1%) patients. Surg to 71 (64%) and SurgEnvas to 12 (10.8%) patients during the treatment process. Preoperative D-dimer (p=0.013). lactate (p=0.006). creatine (p=0.001). LAR (p=0.031) were significantly different between the groups when compared according to the treatment process. The resected bowel length was significantly less in patients who underwent EnvasSurg compared to the other groups (p=0.002), CCI (p=0.041), D-dimer (p=0.016), lactate (p<0.001), creatine (p<0.001), LAR (p<0.001) and ischemia length (p<0.001) were found to be significantly different between the groups.
The prognosis can be predicted with serum-based blood tests and indicators at the time of diagnosis, and organ loss and prognosis can be changed with the selected treatment process.
旨在比较急性肠系膜缺血（AMI）的预后危险因素及影响死亡率的多学科治疗方法。
我们回顾性分析了2012年1月至2023年1月期间接受急性肠系膜缺血治疗的111例患者。在早期调查（术后28天）时，将患者分为存活和死亡两组。比较两组的特征，并调查影响早期死亡率的因素。研究影响围手术期缺血的存在、缺血时间、切除肠段长度以及从Treitz韧带起剩余小肠长度的因素。分析不同治疗过程的结果。
平均年龄为71.67岁，男性64例（57.6%），女性47例（42.3%）。早期死亡率为47.7%。治疗过程中，9例（8.1%）患者应用了Envas，19例（17.1%）患者应用了EnvasSurg，71例（64%）患者接受了手术（Surg），12例（10.8%）患者接受了手术联合Envas（SurgEnvas）。根据治疗过程比较，术前D-二聚体（p=0.013）、乳酸（p=0.006）、肌酐（p=0.001）、LAR（p=0.031）在两组之间存在显著差异。与其他组相比，接受EnvasSurg的患者切除肠段长度明显更短（p=0.002），两组之间的CCI（p=0.041）、D-二聚体（p=0.016）、乳酸（p<0.001）、肌酐（p<0.001）、LAR（p<0.001）和缺血时间（p<0.001）存在显著差异。
在诊断时可通过基于血清的血液检测和指标预测预后，并且所选的治疗过程可改变器官损失和预后。
