随着外科技术和围手术期治疗水平日益提高，腹主动脉瘤择期手术治疗死亡率已控制在5%以内［1，2］，但破裂腹主动脉瘤（ruptured abdominal aortic aneurysm,RAAA）的死亡率一直在40%～70%，如果包括尚未到达医院的RAAA患者，死亡率可达80%～90%，RAAA被美国列为第13位死亡原因［2~4］。目前，及时准确的诊断和快速有效的外科治疗仍是降低RAAA死亡率的关键。......
Open surgery is an important part of vascular surgery. For vascular surgery diseases not suitable for endovascular therapy, adjuvant methods of endovascular therapy and the ultimate means of treatment after failure, vascular graft infection, open vascular trauma, various tumors involving blood vessels, vascular reconstruction and complications of organ transplantation, iatrogenic vascular injury, and so on, open surgical procedures still need to be provided for treatment and development. This paper lists the important role that open surgery plays in supporting the treatment of vascular related diseases and the development of the discipline in surgery and internal medicine, and emphasizes that open surgery is still a necessary quality for vascular surgeons, the basis and important guarantee for the development of the discipline, and the guarantee for the timely and effective treatment of various complex and difficult vascular surgical diseases.
Surgical intervention for chronic thoracoabdominal aortic dissecting aneurysms (cTAADA) is regarded as one of the most challenging procedures in the field of vascular surgery. For nearly six decades, open repair predominantly utilizing prosthetic grafts has been the treatment of choice for cTAADA. With advances in minimally invasive endovascular technologies, two novel surgical approaches have emerged: total endovascular stent-graft repair and hybrid procedures combining retrograde debranching of visceral arteries with endovascular stent-graft repair (abbreviated as hybrid procedure). Although total endovascular stent-graft repair offers reduced trauma and quicker recovery, limitations persist in clinical application due to hostile anatomical requirements of the aorta, high costs, and the lack of universally available stent-graft products. Hybrid repair, integrating the minimally invasive ethos of endovascular repair with visceral artery debranching techniques, has increasingly become a significant surgical modality for managing thoracoabdominal aneurysms, especially in cases unsuitable for open surgery or total endovascular treatment due to anatomical constraints such as aortic tortuosity or narrow true lumens in dissections. Recent enhancements in hybrid surgical approaches include ongoing optimization of visceral artery reconstruction strategies based on hemodynamic analyses, and exploration of the comparative benefits of staged versus concurrent surgical interventions.
Objective To investigate pathogenesy and therapeutic prospect of diabetes mellitus accompanied lower limb vascular lesion. Methods Relevant literatures of recent years were reviewed. Results Diabetes mellitus is one of the main risk factor causing peripheral artery disease. The site of vascular lesion often occur in major blood vessel and micrangium. The arterial sclerosis and decreased blood supply in microcirculation are important factors of lower limb ischemia. Lower limb ischemia in patients with diabetes mellitus is a common complication. Medical treatment and surgical treatment are the methods to improve symptoms of the complication. Conclusion Surgical therapy is an effective method for the treatment of diabetes mellitus accompanied lower limb vascular lesion.
ObjectiveTo evaluate optimal surgical timing of high ligation and ambulatory phlebectomy in treatment of primary great saphenous varicose vein. MethodsThe patients who met the inclusion criteria were divided into simple varicose vein (C2) group and soft tissue complications (C3-C4) group.All the patients were received high ligation and ambulatory phlebectomy.The surgery-related indexes,hospital costs,improvement of quality of life,postoperative recurrence rate were observed. ResultsAll the operations were successful.The operative time,the number of operative incision,and the hospital costs in the C2 group were significantly less than those in the C3-C4 group (P<0.05).The total postoperative complications rate in the C2 group was significantly lower than that in the C3-C4 group (P<0.05).The postoperative AVVQ score on month 3 in the C2 group was significantly lower than that in the C3-C4 group (P<0.05).The postoperative recurrence rate on month 3 had no statistical significance between these two groups (P>0.05). ConclusionsEarly stage (C2) is the optimal surgical timing of primary great saphenous varicose vein,benefits of surgery and health economics in early stage are significantly better than those in mid-advanced stage (C3-C4).It is suggested that surgery should be underwent at early stage in patients with primary great saphenous varicose vein.