腹主动脉瘤的开放手术

Open aortic repair of abdominal aortic aneurysm

腹主动脉瘤(abdominal aortic aneurysm, AAA)是血管外科的常见疾病,传统开放手术(open aortic repair, OAR)或腔内修复(endovascular aortic repair, EVAR)是仅有的有效治疗手段。OAR在20世纪50至90年代达到鼎盛,因其本身的创伤性、技术的复杂性、EVAR技术的迅猛发展等原因,应用已逐渐减少,但在基础研究、年轻患者及感染性AAA等情况中,OAR的作用仍然不可替代。本文回顾OAR的历史和现状,分析其优势和劣势,并讨论术中关键技术要点及并发症的处理,总结在EVAR时代OAR所扮演的角色和地位。

Abdominal aortic aneurysm(AAA)is a common disease in vascular surgery.Traditional open aortic repair(OAR)or endovascular aortic repair(EVAR)is the only effective treatment.OAR reached its peak between 1950s and 1990s,and due to its trauma,technical complexity and the rapid development of EVAR technology,the application of OAR has gradually decreased.However,the role of OAR is still irreplaceable in basic research,young patients and mycotic AAA.This study reviewed the history and current situation of OAR,analyzed its advantages and disadvantages,discussed the key points of intraoperative techniques and the management of complications,and summarized the role and position played by OAR in the EVAR era.