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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/1902

 
Title :[総説]当科における感染性大動脈瘤手術症例の検討
Title alternative :Surgical Treatment of Infectious Aortic Aneurysm
Authors :山城, 聡
前田, 達也
中村, 修子
喜瀬, 勇也
上原, 協
上原, 忠大
稲福, 斉
仲栄真, 盛保
兼城, 隆雄
盛島, 裕次
永野, 貴昭
新垣, 勝也
平安, 恒男
國吉, 幸男
Authors alternative :Yamashiro, Satoshi
Maeda, Tatsuya
Nakamura, Syuko
Kise, Yuya
Uehara, Kanou
Uehara,Tadafumi
Inafuku, Hisashi
Nakaema, Moriyasu
Kaneshiro, Takao
Morishima,Yuji
Nagano, Takaaki
Arakaki, Katsuya
Hirayasu, Tuneo
Kuniyoshi, Yukio
Authors affiliation :琉球大学医学部生体制御医科学講座機能制御外科学分野
Issue Date :2007
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346-888X
0289-1530
Abstract :Objectives; The surglcal results of infectious aortic aneurysm are still unsatisfactory because the operation is usually performed on an emergency basis while the patient is in a state of sepsis or shock from aneurismal rupture. Furthermore, patients face the risk of postoperative graft infection even if the operation is successful. Although various operative procedures and devices for preventing postoperative graft infection have been reported, there is no definitive method of preventing such postoperative infectious complications. Patients and methods; Seventeen patients of infectious aortic aneurysm were treated surgically between January 1995 and April 2007. Five of the 17 patients with infectious aortic aneurysm were female and 12 were male; their ages ranged from 39 to 83 years, with a mean of 66.2years. The aneurysms were located in ascending aorta in 1 patient, aortic arch in 1, descending aorta in 6, thoracoabdominal aorta in 5, and infrarenal abdominal aorta in4. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. One of those 3 patients suffered cardiac arrest just before the operation. The diagnoses of infectious aortic aneurysm were established before operation in 15 patients. Underlying disorders related to infectious aortic aneurysm were history of surgical excisions for malignancy in 5 patients. All patients underwent complete resection of their infectious aneurismal wall with surrounding infectious tissue and in-situ graft placementIn12patients,the replace graft was covered with a pedicled omental. flap to prevent postoperative graft infection. after packing with sponges soaked in 10% iodine solution for 48 hours lately. Results; There were 3 hospital deaths (hospital mortality, 17.6%); one patient died of multi-organ failure, one patient died from intrathoracic bleeding, and the other died from intestinal necrosis. After discharge, one patient died from intrathoracic bleeding due to graft infection (infection related death). The other 3 patients died from non-infection related causes during follow-up period. These 4 patients died at postoperative long-term period had not received omental wrapping.Postoperative graft infection have not occurred in 9 survivlng patients during a mean followup period of 6.3+/- 4.3years. with a maximum of 11.2years. Conclusion; These results suggest that coverlng the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surglcal results.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/1902
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.26 no.3・4 p.99 -104
Appears in Collections:Ryukyu Medical Journal

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