Pokrovsky A V, Kasantchjan P O
Ann Surg. 1980 Jan;191(1):51-6. doi: 10.1097/00000658-198001000-00010.
Whenever abdominal circulatory disorders are caused by obstruction of the abdominal aortic visceral branches, adequate blood flow may be restored only by surgical intervention. With the development of symptoms suggesting inadequate collateral circulation and disturbance of splanchnic blood supply, operation is indicated. The choice of operation depends on the nature and the cause of the disease and the type of occlusion. With intravascular obstruction, correction of blood flow may be achieved by a reconstructive procedure. In many patients with extravascular compression of the celiac artery, adequate flow is restored by simple external decompression. The present communication is based on experience with 119 operations, 102 reconstructive and 17 decompressive. Of the 102 reconstructive procedures, 94 were complex with one-stage revascularization of several arteries. Transaortic endarterectomy as described in our method of choice although with widespread lesions resection and replacement is preferred. A thoracolumbar approach is the most expedient incision for reconstruction. The results obtained provide evidence for the effectiveness of surgical treatment of chronic occlusive disease of the visceral branches of the abdominal aorta.
每当腹主动脉内脏分支阻塞导致腹部循环障碍时，只有通过手术干预才能恢复足够的血流。当出现提示侧支循环不足和内脏血液供应紊乱的症状时，就应进行手术。手术方式的选择取决于疾病的性质、病因和闭塞类型。对于血管内阻塞，可通过重建手术来纠正血流。在许多腹腔动脉血管外受压的患者中，通过简单的外部减压即可恢复足够的血流。本报告基于119例手术的经验，其中102例为重建手术，17例为减压手术。在102例重建手术中，94例较为复杂，需对多条动脉进行一期血管重建。我们所选用的经主动脉内膜切除术虽然适用于广泛病变，但首选的还是切除和置换。胸腰段入路是重建手术最便捷的切口。所获得的结果证明了对腹主动脉内脏分支慢性闭塞性疾病进行手术治疗的有效性。
