腹腔镜下主-双股动脉人工血管旁路移植术治疗髂动脉闭塞

Laparoscopic Aorto-bilateral Femoral Arteries Graft Bypass for Iliac Artery Occlusion

本文报道2011年11月腹腔镜协助下成功治疗1例腹主动脉-股动脉闭塞,完全腹腔镜下使用涤纶Y形人工血管行近端腹主动脉吻合,人工血管远端经腹膜后隧道与双侧股动脉吻合,再使用聚四氟乙烯人工血管吻合涤纶血管至膝下腘动脉。吻合口无漏血,远端血运恢复。术后20天复查CTA,移植血管通畅。术后1个月复查,间歇性跛行症状消失,踝肱指数明显升高,分别由0.61升至0.81(左),0.41升至1.07(右)。

This paper reports a successful laparoscopic-assisted procedure for abdominal aortic-femoral arterial occlusion in November 2011.Under a laparoscope,we performed proximal aortic anastomosis by using Y-type polyester prosthesis.Through a retroperitoneal tunnel the prosthesis were anastomosed with the bilateral femoral arteries.And then polytetrafluoroethylene graft was used to accomplish the anastomosis with the popliteal artery below the knee.After the procedure,no anastomotic leakage occurred,and the distal blood supply restored in all the cases.At day 20 postoperation,CTA showed patent grafts.At 1 month,reexamination showed increased bilateral ankle-brachial indice（left： from 0.61 to 0.81,right： 0.41 to 1.07）,and intermittent claudication disappeared in all the patients.