CAJ | 학술논문

目的探讨腹腔镜主股动脉转流术治疗主髂闭塞性疾病的可行性和安全性.方法回顾性分析18例主髂闭塞性疾病患者应用腹腔镜主股动脉转流术的治疗情况,评价手术的可行性、解剖要点、术中主动脉阻断时间、出血量、ICU停留时间等.结果 18例中,17例接受完全腹腔镜主股动脉转流手术患者获得成功.1例主双髂动脉闭塞患者因腹主动脉壁严重钙化而中转开放手术.平均手术时间(280±57) min,平均主动脉阻断时间(117 ±32) min,术中平均失血(524±45) ml,平均ICU监护时间(1.0±1.2)d,平均术后进食时间(3±3)d,平均术后住院时间(10±5)d.术后发生心肌梗死1例、肺部感染2例均在ICU监护治疗后好转,发生人工血管内血栓形成1例,再次手术取栓,术后通畅.本组18例患者均获随访,随访时间3～ 27个月,平均随访时间(18±8)个月.人工血管均保持通畅.结论腹腔镜主股动脉转流手术治疗主髂动脉闭塞性疾病是安全可行的,微创手术有利于患者恢复.
목적 탐토복강경주고동맥전류술치료주가폐새성질병적가행성화안전성.방법 회고성분석18례주가폐새성질병환자응용복강경주고동맥전류술적치료정황,평개수술적가행성、해부요점、술중주동맥조단시간、출혈량、ICU정류시간등.결과 18례중,17례접수완전복강경주고동맥전류수술환자획득성공.1례주쌍가동맥폐새환자인복주동맥벽엄중개화이중전개방수술.평균수술시간(280±57) min,평균주동맥조단시간(117 ±32) min,술중평균실혈(524±45) ml,평균ICU감호시간(1.0±1.2)d,평균술후진식시간(3±3)d,평균술후주원시간(10±5)d.술후발생심기경사1례、폐부감염2례균재ICU감호치료후호전,발생인공혈관내혈전형성1례,재차수술취전,술후통창.본조18례환자균획수방,수방시간3～ 27개월,평균수방시간(18±8)개월.인공혈관균보지통창.결론 복강경주고동맥전류수술치료주가동맥폐새성질병시안전가행적,미창수술유리우환자회복.
Objective To investigate the feasibility and safety of laparoscopic aortobifemoral bypass (LABF) for diffuse aortoiliac occlusive diseases.Methods Clinical data of 18 cases who underwent LABF were retrospectively analyzed.The intraoperative procedures and postoperative outcome were evaluated.Results LABF was performed successfully in 17 of 18 patients.The mean operation time was (280 ±57) minutes,with a mean aortic cross-clamp time of (117 ±32) minutes.Estimated blood loss was(524 ±45) ml.Mean ICU stay was ( 1.0 ± 1.2) days.The mean postoperative hospital stay was ( 10 ±5) days.Mean time to resume diet was (3 ± 3 ) days.Postoperative myocardial infarction developed in 1 case,lung infection in 2 cases.There was no perioperative mortality.Graft thrombosis developed in 1 case and embolectomy surgery was successfully performed.All patients were followed up from 3 to 27 months,with mean follow-up of (18 ± 8) months,grafts were all patent.Conclusions Laparoscopic aortic bypass is feasible and miniinvasive in patients with diffuse aortoiliac occlusive disease.Short-term outcomes are comparable to those with open conventional aortic bypass.