Long-term Results of the Surgical Treatment of Intra-mural Hematomas of the Descending Thoracic Aorta

Background Replacement of the descending thoracic aorta is traditionally performed via a left thoracotomy. Endovascular treatment of descending thoracic aortic aneurysms has recently evolved as an alternative treatment for selected patients, yet no long-term results are available. The authors replaced the descending thoracic aorta in a group of pigs with an interposition Dacron graft using a closed-chest, totally robotic technique. Methods Ten pigs, weighing 25 to 45 kg, underwent surgery using the DaVinci robotic surgical system. Under single-lung ventilation and CO2 insufflation, the descending thoracic aorta was completely mobilized. Proximal and distal cross-clamps were applied through separate accessory stab wounds. The mid-descending thoracic aorta was excised. An interposition Dacron graft was robotically sewn in an end-to-end fashion to the descending thoracic aorta using interrupted nitinol clips. Results All animals survived the procedure. Mean aortic clamp time was 55 ± 14 minutes. All anastomoses were completed without difficulty with a mean total anastomotic time of 42 ± 11 minutes. The anastomoses were challenged for bleeding by administrating α1-adrenergic receptor agonists to a systolic blood pressure of 200 mm Hg with no evidence of leak. Discussion Robotic replacement of the thoracic aorta is feasible and reproducible. This procedure provides the standard Dacron graft repair with its known long-term results. The added value of robotic technology to the therapeutic armamentarium in the treatment of thoracic aortic aneurysms may be worth the effort required for procedural development. Furthermore, it may serve as a valid alternative to endovascular treatment of thoracic aortic aneurysms.

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Treatment of traumatic rupture of the thoracic aorta

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0810498d ◽

2008 ◽

Vol 136 (9-10) ◽

pp. 498-504 ◽

Cited By ~ 1

Author(s):

Lazar Davidovic ◽

Miroslav Markovic ◽

Momcilo Colic ◽

Nikola Ilic ◽

Igor Koncar ◽

...

Keyword(s):

Surgical Treatment ◽

Mortality Rate ◽

Endovascular Treatment ◽

Thoracic Aorta ◽

Good Condition ◽

Long Term Results ◽

Traumatic Rupture ◽

Published Data ◽

Aorta Rupture

INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74). RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25%) patients died, while two (16.6%) had paraplegia. Nine patients (75%) were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years). CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases) or external heparin-bonded shunts (five of our cases). Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

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Surgical treatment of trigonocephaly: technique and long-term results in 48 cases

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2011.05.060 ◽

2011 ◽

Vol 2011 ◽

pp. 282

Author(s):

P. Klimo

Keyword(s):

Surgical Treatment ◽

Long Term Results

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Long-term results of radiofrequency ablation used for the surgical treatment of atrial fibrillation associated with rheumatic mitral valve disease

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0029-1191713 ◽

2009 ◽

Vol 56 (S 01) ◽

Author(s):

I Tzanavaros ◽

I Bergfeld ◽

A Rajca ◽

V Herwig ◽

A Heyde ◽

...

Keyword(s):

Atrial Fibrillation ◽

Surgical Treatment ◽

Radiofrequency Ablation ◽

Mitral Valve ◽

Mitral Valve Disease ◽

Valve Disease ◽

Long Term Results

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Short- and long-term outcomes after endovascular management of ruptured descending thoracic aorta

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0029-1247037 ◽

2010 ◽

Vol 58 (S 01) ◽

Author(s):

B Rylski ◽

M Siepe ◽

M Südkamp ◽

C Schlensak ◽

W Euringer ◽

...

Keyword(s):

Thoracic Aorta ◽

Endovascular Management ◽

Descending Thoracic Aorta ◽

Long Term Outcomes ◽

Short And Long Term

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Temporary “liquid” Implant for Congenital Glaucoma (long-term results)

International scientific-practical journal Ophthalmology ◽

10.30702/ophthalmology30092020-11.1.2049-65 ◽

2020 ◽

pp. 49-65

Author(s):

N Bobrova ◽

N Trofimova

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Hypotensive Effect ◽

Congenital Glaucoma ◽

Long Term Results ◽

General Will ◽

Visual Functions ◽

Advanced Stages ◽

Intraocular Fluid

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular ﬂuid outﬂow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.

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SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

Problems in oncology ◽

10.37469/0507-3758-2017-63-1-146-152 ◽

2017 ◽

Vol 63 (1) ◽

pp. 146-152

Author(s):

Mikhail Ter-ovanesov ◽

Aleksandr Levitskiy ◽

E. Lesnidze ◽

Aram Gaboyan ◽

Mariya Kukosh ◽

...

Keyword(s):

Surgical Treatment ◽

Long Term Results ◽

Esophageal Reconstruction ◽

Gastroesophageal Cancer ◽

Colonic Interposition ◽

Simultaneous Application ◽

High Involvement ◽

Surgical Access ◽

Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

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