Open or endovascular repair of aortoenteric fistulas? A multicentre comparative study

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Μικρογραφία εικόνας

Ημερομηνία

Συγγραφείς

Kakkos, S. K.
Antoniadis, P. N.
Klonaris, C. N.
Papazoglou, K. O.
Giannoukas, A. D.
Matsagkas, M. I.
Kotsis, T.
Dervisis, K.
Gerasimidis, T.
Tsolakis, I. A.

Τίτλος Εφημερίδας

Περιοδικό ISSN

Τίτλος τόμου

Εκδότης

Περίληψη

Τύπος

Είδος δημοσίευσης σε συνέδριο

Είδος περιοδικού

peer-reviewed

Είδος εκπαιδευτικού υλικού

Όνομα συνεδρίου

Όνομα περιοδικού

Eur J Vasc Endovasc Surg

Όνομα βιβλίου

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Έκδοση βιβλίου

Συμπληρωματικός/δευτερεύων τίτλος

Περιγραφή

OBJECTIVES: To compare aortoenteric fistula (AEF) outcome after endovascular (EV-AEFR) or open repair (O-AEFR). DESIGN: Multicentre retrospective comparative study. MATERIALS/METHODS: 25 patients with AEF (24 secondary, 23 males, median age 75 years) after aortic surgery (median four years). Preoperative sepsis was evident in 19 cases. Eight patients were managed with EV-AEFR and 17 with O-AEFR. RESULTS: The two groups were comparable in preoperative characteristics. In-hospital mortality after EV-AEFR was lower compared to O-AEFR (0% and 35%, respectively, p = 0.13). Similarly, morbidity after EV-AEFR was lower compared to O-AEFR (25% and 77%, respectively, p = 0.028). There was a trend for worse recurrence-free, sepsis-free, re-operation-free and AEF-related death-free rates after EV-AEFR, while the early survival advantage of EV-AEFR was lost after two years and the overall long-term survival rates (perioperative mortality included) of the two groups were similar. Preoperative sepsis had no effect on recurrence and sepsis-free rates (p = 0.94 and p = 0.92, respectively), but it was associated with worse two year overall survival (24% vs 50%, p = 0.32). On multivariate analysis, the number of symptoms (two vs one) at presentation was the single predictor of worse re-operation rates, AEF-related and overall survival. CONCLUSIONS: EV-AEFR was associated with no postoperative mortality in this study and can achieve satisfactory short and long-term results, comparable to O-AEFR. Further trials should focus on the role of EV-AEFR in patients at high risk for O-AEFR, due to shock or co-morbidities, or as a bridging procedure.

Περιγραφή

Λέξεις-κλειδιά

Aged, Aged, 80 and over, *Aorta, Abdominal, Aortic Diseases/diagnosis/*surgery, Female, Follow-Up Studies, Humans, Intestinal Fistula/diagnosis/*surgery, Male, Middle Aged, Retrospective Studies, *Stents, Tomography, X-Ray Computed, Treatment Outcome, Vascular Fistula/diagnosis/*surgery, Vascular Surgical Procedures/*methods

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Σύνδεσμος

http://www.ncbi.nlm.nih.gov/pubmed/21324718
http://ac.els-cdn.com/S1078588411000153/1-s2.0-S1078588411000153-main.pdf?_tid=5164bcfd68805885a40d4a2f66cd9b4d&acdnat=1333635190_733986c3e645893c46d7d5e8affc1e40

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en

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Εξεταστική επιτροπή

Γενική Περιγραφή / Σχόλια

Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος

Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής

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Χορηγός

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