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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2003 June;10(2):97-110
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
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.