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目的探讨腹主动脉瘤合并需外科手术的消化系统疾病的外科治疗方法。方法回顾性分析16例腹主动脉瘤合并消化系统疾病进行手术治疗患者的临床资料,总结处理经验。腹主动脉瘤与消化系统疾病同期手术12例(同时行胆囊切除术5例,结肠癌根治术7例),腹主动脉瘤腔内治疗后行结肠癌根治术2例、食道下段癌根治术1例,先行胃癌根治术后再行腹主动脉瘤手术1例。结果发生食道胃吻合口瘘1例,术后第2天死亡。胃瘫1例,经保守治疗30d后恢复。14例存活8～60个月,无人工血管感染,无血管支架内漏,无肿瘤复发。结论腹主动脉瘤与消化系统疾病并存,只要全身和局部情况允许,应争取同期手术,反之应分期手术,合适病例在腹主动脉瘤腔内治疗后,再行消化系统疾病手术,这是一种安全、有效的方法。
Objective To investigate the surgical treatment of digestive system diseases with abdominal aortic aneurysm complicated with surgery. Methods The clinical data of 16 patients with abdominal aortic aneurysm complicated by digestive diseases were analyzed retrospectively. The treatment experience was summarized. Abdominal aortic aneurysm and digestive system diseases in the same period 12 cases (concurrent cholecystectomy in 5 cases, colon cancer radical operation in 7 cases), abdominal aortic aneurysm after endovascular treatment of colon cancer in 2 cases, radical esophagectomy 1 case, the first radical gastrectomy and abdominal aortic aneurysm surgery in 1 case. One case of gastroesophageal anastomotic leakage occurred and died on the second day after operation. Gastroparesis in 1 case, after conservative treatment 30d recovery. Fourteen patients survived for 8 to 60 months with no artificial vascular infection, no vascular stent leakage, and no tumor recurrence. Conclusions Abdominal aortic aneurysm coexists with digestive system diseases. Surgery should be pursued in the same period as long as systemic and local conditions are allowed. On the contrary, staged surgery should be performed. In the appropriate cases, after endovascular treatment of abdominal aortic aneurysm, digestive system diseases should be performed again. A safe and effective way.