RESUMO
Abdominal aortic aneurysm was detected in 269 patients and 26 (9.6%) of them had a coincidental malignancy. There were 25 (96.2%) men and 1 (3.8%) woman of age from 46 to 88 years (on the average 67.9 +/- 1.7 years old). All of them had different accompanying diseases, influencing the choice of treatment strategy. More than half of patients (16 (61.5%) had the advanced stage III or IV (3H) of cancer and three of them occupied the first place due to their wide occurrence: tumors of lung--42.3%, of stomach--19.2%, of large intestine--11.5%. The operations were performed in 8 patients with malignancy and in 2 patients with abdominal aortic aneurysm. Two-step operations were performed in 4 patients, the simultant operation--in one patient.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Neoplasias/diagnóstico , Procedimentos Cirúrgicos Vasculares/normas , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/epidemiologia , Estudos Retrospectivos , Federação Russa/epidemiologia , Taxa de Sobrevida/tendências , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia Doppler em CoresRESUMO
Retrospective analysis of data in 188 patients showed, that chronic nonspecific pulmonary disease was diagnosed in 65.4% of all. Disorders of bronchial patency of different degrees of manifestation were noted in 61.2% and 19.7% of patients had a hypoxemia. Renal diseases were found in 59% of patients, resulting in the development of chronic renal insufficiency in 17%. The data obtained indicate, that the presence of coexisting pulmonary pathology directly influences the frequency and severity of respiratory complications after surgery, which can be the cause of fatal outcome. The presence of renal diseases results in three times higher risk of the development of postoperative renal complications.
Assuntos
Aneurisma da Aorta Abdominal/complicações , Insuficiência Renal/complicações , Insuficiência Respiratória/complicações , Procedimentos Cirúrgicos Vasculares , Adulto , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/cirurgia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Insuficiência Renal/diagnóstico , Insuficiência Renal/epidemiologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Federação Russa/epidemiologia , Taxa de Sobrevida/tendências , Resultado do TratamentoRESUMO
A comparative analysis was made of clinical indices and long-term survival in 20 patients (13 men and 7 women of mean age 62 +/- 2 years), having multifocal atherosclerosis of the renal arteries (RA), abdominal aorta and arteries of lower extremities (LE) (11 aneurysms, 7 occlusive lesions of the aorta and 3 of its unpaired branches) who underwent combined reconstructions, with patients having similar lesions, but not operated (12) or operated only on RA or on the arteries of LE (45). The groups of patients had no great differences except more pronounced renal dysfunction (RD) in the first of them. In spite of high postoperative lethality (20%) mainly due to acute renal failure (3), long-term survival proved to be significantly higher (14 from 16), than in not operated (3 from 12) (p = 0.00001) and had better tendency than in those operated on the same basin (35 from 45). In addition, the patients after combined operations had substantially decreased systolic and diastolic arterial pressure (159 +/- 13 vs. 132 +/- 9, p = 0.00001; 91 +/- 5 vs. 83 +/- 7, p = 0.010) and also stabilized renal function.
Assuntos
Aorta Abdominal/cirurgia , Endarterectomia , Monitorização Fisiológica/métodos , Obstrução da Artéria Renal/cirurgia , Artéria Renal/cirurgia , Aorta Abdominal/fisiopatologia , Aterosclerose/complicações , Aterosclerose/fisiopatologia , Determinação da Pressão Arterial , Pesquisa Comparativa da Efetividade , Endarterectomia/efeitos adversos , Endarterectomia/métodos , Feminino , Humanos , Hipertensão Renovascular/diagnóstico , Hipertensão Renovascular/etiologia , Testes de Função Renal , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Artéria Renal/fisiopatologia , Obstrução da Artéria Renal/etiologia , Obstrução da Artéria Renal/fisiopatologia , Insuficiência Renal/diagnóstico , Insuficiência Renal/etiologia , Índice de Gravidade de Doença , Análise de Sobrevida , Resultado do TratamentoAssuntos
Doenças da Aorta , Arteriopatias Oclusivas , Malformações Arteriovenosas , Rim , Enxerto Vascular/métodos , Aorta/fisiopatologia , Aorta/cirurgia , Doenças da Aorta/complicações , Doenças da Aorta/congênito , Doenças da Aorta/fisiopatologia , Doenças da Aorta/cirurgia , Aortografia/métodos , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/congênito , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/cirurgia , Malformações Arteriovenosas/diagnóstico , Malformações Arteriovenosas/fisiopatologia , Malformações Arteriovenosas/cirurgia , Humanos , Hipertensão Renovascular/etiologia , Hipertensão Renovascular/fisiopatologia , Artéria Ilíaca/fisiopatologia , Artéria Ilíaca/cirurgia , Rim/irrigação sanguínea , Rim/fisiopatologia , Masculino , Artéria Renal/fisiopatologia , Artéria Renal/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
Mycotoc aneurysms (MA)--a rare and extremely dangerous lesion of the aorta. CT, MRA and aortography were used to diagnose MA of the thoracoabdominal areas in 2 men of 64 and 67 years of age. The clinical picture included: fever with shivering with the temperature 38-39 degrees C and increasing pains in the inferiothoracic and lumbar areas of the spine. Hemoculture was positive in 1 patient only. The patients were operated on. Shunting of the aorta from the inferiothoracic to infrarenal segments was performed in one patient with the exclusion of the involved portion and resection of MA. Metalloosteosynthesis of the spine due to destruction of LI-LII and compression of the spine were performed in the second patient followed by analogous shunting of the aorta and visceral arteries with the resection of the aneurysm. To prevent infection of the prostheses the shunts were wrapped up with a piece of the greater omentum. One patient died two months later from recurrent sepsis. The other one is alive, within 28 months the shunts are patent, there are no signs of a reinfection.