一站式复合手术在非心血管外科疾病中的应用

Application of one-stop hybrid procedure in non-cardiovacular surgical diseases

目的探讨一站式复合手术在非心血管外科疾病治疗方面的临床应用。方法收集2010年8月至2012年1月,9例在我院复合手术室实施一站式复合手术的非心血管外科病例。所有病例术前均先行血管造影,明确病灶供血动脉,根据外科医生要求放置球囊阻断或栓塞血管,再手术切除病灶。结果本组病例中供血动脉临时阻断3例,栓塞9例,同时行动脉主干阻断及分支栓塞2例。手术方式包括股动脉假性动脉瘤感染清创术3例,腹膜后巨大肿瘤切除术3例,肾巨大错构瘤切除术2例,第5腰椎肿瘤切除并腰椎重建术1例。手术时间140～390 min,术中出血60～250 mL。病人均康复出院。结论对于高风险的非心血管外科疾病,采用一站式复合手术可减少术中出血和并发症的发生。

Objective To explore the application of one-stop hybrid procedure in non-cardiovacular surgical diseases. Methods From August 2010 to January 2012,9 patients with non-cardiovascular surgical diseases underwent OSHP in our hospital were collected. All patients were performed with angiography. According to the requirement of the surgeons, the intralesional excision of the nidus in supplying arteries were performed. Results The supplying arteries were blocked in 3 patients and embolized in 9 cases. The main supplying arteries were blocked and the branches were embolized simultaneously in 2 patients. The procedures included debridement of infected femoral pseudoaneu- rysm in 3 patients, giant retroperitoneal tumors resection in 3 cases, giant renal hamartoma resection in 2 cases, and the L5 with tumor resec- tion and reconstruction in 1 patient. The operating time was 40 - 390 rain and the intraoperative blood loss was 60 - 250 mL. Postoperative courses were uneventful in all patients. Conclusion One-stop hybrid procedure could decrease intraoperative blood loss and morbidity for the risky non-cardiovascular surgical diseases.