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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 2003 June;10(2):97-110

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Conventional surgical treatment of secondary aorto-enteric fistula

Dorigo W., Pulli R., Azas L., Pratesi C.

Cattedra e Scuola di Specializzazione in Chirurgia Vascolare, Università degli Studi di Firenze, Firenze


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Background. To ret­ro­spec­tive­ly eval­u­ate ear­ly and ­late ­results of sur­gi­cal treat­ment of sec­on­dary aor­to-enter­ic fis­tu­las ­with pros­thet­ic exci­sion and ­extra-ana­tom­ic ­bypass (con­ven­tion­al treat­ment).
Methods. Between January 1990 and March 2002, a ­total of 30 ­patients under­went con­ven­tion­al sur­gi­cal treat­ment for sec­on­dary aor­to-enter­ic fis­tu­la (­SAEF). Operative ­data ­were col­lect­ed in a ded­i­cat­ed data­base; 30-day mor­tal­ity, paten­cy and ­limb sal­vage ­rates ­were ­then ana­lyzed ­using the χ2 ­test and uni­var­i­ate anal­y­sis. Clinical and ultra­so­nog­ra­phy fol­low-up exam­ina­tions ­were per­formed; ­late ­results ­were com­pared ­using Kaplan-Meier ­curves.
Results. Thirty-day mor­tal­ity ­rate was 26.5% (8 ­patients). Timing and ­sequence of inter­ven­tions (simul­ta­ne­ous or ­staged, ­sequence of pros­thet­ic exci­sion and revas­cu­lar­iza­tion) had no sig­nif­i­cant influ­ence on per­i­op­er­a­tive mor­tal­ity. Primary and sec­on­dary paten­cy ­rates at 30 ­days ­were 80% and 100%, respec­tive­ly. Mean dura­tion of fol­low-up was 24 ­months; 12-­month and 24-­months sur­vi­val ­rates ­were 80% and 65%, respec­tive­ly. Primary paten­cy ­rate was 89% and ­limb sal­vage ­rate was 93%, at 24 ­months. Two pros­thet­ic ­graft re-in­fec­tions devel­oped dur­ing fol­low-up (9%). Cumulative re-inter­ven­tion ­rate dur­ing fol­low-up was 18%.
Conclusions. Conventional sur­gi­cal treat­ment of sec­on­dary aor­to-enter­ic fis­tu­la pro­duced ­good ear­ly- and ­long-­term ­results, ­with sat­is­fac­to­ry ­rates of paten­cy and ­limb sal­vage. Surgical tim­ing and ­sequence do not ­seem to ­affect ear­ly- or ­long-­term ­results.

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