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在复杂的大动脉内移植中,手术时间和术后结果之间的关联:单个中心的回顾性观察研究

Federico F Pennetta¹, Thomas Le Houérou¹, Mickael Palmier¹

¹Vascular Surgery, Aortic Centre, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris Saclay, Paris, France.

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

|September 7, 2025

概括

在复杂的内血管大动脉修复中,延长的操作时间 (OT) 与更高的30天死亡率有关. 在研究期间,操作时间减少,显示了学习曲线效应和改善的结果.

科学领域:

血管外科血管外科
血管内修复血管内修复
外科手术的结果

背景情况:

复杂的内血管大动脉修复 (EVAR) 包括窗口 (FEVAR),分支 (BEVAR) 和弧形分支 (aBEVAR) 的程序.
操作时间 (OT) 是手术过程中的关键指标,可能会影响患者的治疗结果.
了解影响OT的因素对于优化复杂的EVAR程序至关重要.

研究的目的:

在复杂的EVAR中评估操作时间 (OT) 和30天术后结果之间的关联.
确定导致OT变化的因素,包括医院体积和学习曲线.
评估长期OT对并发症和死亡率的影响.

主要方法:

对530名接受复杂EVAR (FEVAR,BEVAR,aBEVAR) 的患者进行了回顾性观察队列研究.
运行时间定义为从第一次动脉接入到关闭的间隔.
分析包括诸如医院体积,学习曲线,辅助程序和技术等因素,以及30天的结果.

主要成果:

平均OT因手术类型而异 (FEVAR: 145 分钟,BEVAR: 181 分钟,aBEVAR: 159.5 分钟).
在最长的OT tertile (9.1%) 与最短的 (0.0%) 相比,三十天死亡率显著更高 (p < .001).
多变量分析证实长时间的OT作为30天死亡率增加的独立预测因子 (aOR为每分钟1.010).
在研究期间,OT下降,表明学习曲线效应 (p < .001).

结论:

经过复杂的EVAR后,长时间的操作时间独立地与30天死亡率的增加有关.
随着时间的推移,随着OT的减少,结果有所改善,这表明了显著的学习曲线效应.
这项单中心研究的结果强调了在复杂的大动脉修复中优化OT的重要性,尽管由于回顾性设计,建议谨慎使用.

关键词:

大动脉门内血管修复贝瓦尔 (BEVAR) 是一个比瓦尔 (BEVAR) 的名字.发烧,就是发烧.上大动脉动脉瘤是上大动脉动脉瘤胸腔腹腔大动脉动脉瘤是什么

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