机构:[1]Department of General Surgery, the First People’s Hospital of Yunnan Province & the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China云南省第一人民医院[2]Department of General Surgery, Kunming University of Science and Technology School of Medicine & Affiliated Hospital and the First People’s Hospital of Yunnan Province, Kunming, China云南省第一人民医院
Background: Thoracoabdominal aortic aneurysms (TAAAs) are one of the most complex aortic aneurysms to treat. Traditional open surgery for TAAAs is highly invasive and total endovascular treatment still has many limitations. Hybrid surgery offers a viable option for TAAA patients, but currently it often alters the original hemodynamics. Therefore, we have developed and applied a hybrid surgery protocol for anatomically suitable TAAA patients. Here we analyzed the short-term outcomes of these patients and evaluated the effectiveness and safety of this procedure. Methods: A new method was used to perform the required artificial revascularization of the abdominal aorta and its branches. A new visceral debranching and reconstruction approach was used to complete an anatomy-conforming open surgery. Finally, a new vascular access was used for the endovascular operation to complete the implantation of stent-grafts. The clinical data of 10 patients with TAAAs treated at our center with the anatomy-conforming hybrid technique during the period from May 2018 to June 2020 was retrospectively analyzed. The intraoperative and 30-day postoperative key indicators, including survival rates and complications, were analyzed. Results: The hybrid surgery was smoothly performed in all 10 patients. One patient died from non-aortic causes (sepsis/infectious toxic shock) 30 days after surgery, yielding a case-fatality rate of 10.0% (1/10). Two patients (2/10) experienced serious complications within 30 days postoperatively, including multi organ failure due to infection in one patient and lower limb ischemia in another patient who went on to develop permanent paraplegia. No endoleak after stent implantation was noted and the blood supply of each reconstructed visceral artery was good. Conclusions: Based on the short-term outcomes, the anatomy-conforming hybrid surgical protocol is safe and effective in treating TAAA patients.
基金:
Supported by Chen Zhong Expert Workstation
Fund of Yunnan Province (2005AF150018).
第一作者机构:[1]Department of General Surgery, the First People’s Hospital of Yunnan Province & the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
通讯作者:
通讯机构:[1]Department of General Surgery, the First People’s Hospital of Yunnan Province & the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China[*1]Department of General Surgery, the First People’s Hospital of Yunnan Province & the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
推荐引用方式(GB/T 7714):
Li Yuejin,Xiao Le,Zhang Peng,et al.Short-term effectiveness and safety of an anatomy-conforming hybrid surgery protocol for thoracoabdominal aortic aneurysms[J].ANNALS OF PALLIATIVE MEDICINE.2021,10(8):8762-8771.doi:10.21037/apm-21-1569.
APA:
Li, Yuejin,Xiao, Le,Zhang, Peng,Zhang, Jian,Guo, Shikui...&Gong, Kunmei.(2021).Short-term effectiveness and safety of an anatomy-conforming hybrid surgery protocol for thoracoabdominal aortic aneurysms.ANNALS OF PALLIATIVE MEDICINE,10,(8)
MLA:
Li, Yuejin,et al."Short-term effectiveness and safety of an anatomy-conforming hybrid surgery protocol for thoracoabdominal aortic aneurysms".ANNALS OF PALLIATIVE MEDICINE 10..8(2021):8762-8771