Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492010005000004
Jornal Vascular Brasileiro
Case Report

Cirurgia aórtica totalmente laparoscópica para tratamento de isquemia crítica de membros: relato do primeiro caso no Brasil

Total laparoscopic aortic surgery for treatment of limb critical ischemia: report of the first case in Brazil

Ricardo de Alvarenga Yoshida; Winston Bonetti Yoshida; Hamilton de Almeida Rollo; Ralf Kolvenbach; Rodrigo Gibin Jaldim; Fernando Cordeiro Pimentel; Aline Helena Gonzáles Fares

http://dx.doi.org/10.1590/S1677-54492010005000004 J Vasc Bras, vol.9, n1, p.66-73, 2010
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Resumo

A cirurgia videolaparoscópica (CVL) vem evoluindo como alternativa cirúrgica menos invasiva para o tratamento da doença aterosclerótica oclusiva aortoilíaca. O objetivo deste relato de caso foi demonstrar os resultados da primeira cirurgia aórtica totalmente laparoscópica relatada no Brasil para o tratamento da doença oclusiva aortoilíaca em paciente com isquemia crítica. Os tempos cirúrgicos totais de dissecção e exposição da aorta antes do clampeamento, exposição retroperitoneal da aorta, clampeamento total e da anastomose proximal com técnica totalmente laparoscópica foram de 220 minutos, 15 e 27 minutos, 42 minutos, 110 minutos e 78 minutos, respectivamente. A técnica videolaparoscópica é mais uma ferramenta minimamente invasiva, viável, segura e eficaz para o tratamento da doença oclusiva aortoilíaca extensa. Ela, que nada mais é do que a cirurgia convencional realizada sob visão laparoscópica, tem bons resultados a longo prazo, que se associam à elegância técnica.

Palavras-chave

Cirurgia videoassistida, aorta, doenças vasculares, aterosclerose

Abstract

Laparoscopic surgery has been increasingly used as a less invasive surgical option for the treatment of aortoiliac occlusive atherosclerotic disease. The objective of this case report was to describe the results of the first total laparoscopic surgery conducted in Brazil for the treatment of the aortoiliac occlusive disease in a patient with critical ischemia. Total time of surgery, time of aortic dissection and exposure before clamping, time of retroperitoneal exposure of the aorta, and time of total clamping and proximal anastomosis using total laparoscopic technique were 220 minutes, 15 and 27 minutes, 42 minutes, 110 minutes, and 78 minutes, respectively. The laparoscopic technique is an additional minimally invasive tool, being feasible, safe, and effective for the treatment of extensive aortoiliac occlusive disease. This technique, which is nothing more than a conventional surgery performed under laparoscopic viewing, brings good long-term results associated with technical elegance.

Keywords

Video-assisted surgery, aorta, vascular diseases, atherosclerosis

References

Yoshida RA, Yoshida WB, Maffei FH. Comparative study of evolution and survival of patients with intermittent claudication, with or without limitation for exercises, followed in a specific outpatient setting. J Vasc Bras.. 2008;7:112-22.

Lastória S, Maffei FH. Aterosclerose obliterante periférica: epidemiologia, fisiopatologia, quadro clínico e diagnóstico. Doenças vasculares periféricas. 2008:1141-55.

Yoshida RA, Yoshida WB, Sobreira M, Silva C. Infrapopliteal angioplasty: the more arteries are treated the better?. J Vasc Bras.. 2008;7:176-82.

Kannel WB, McGee DL. Update on some epidemiologic features of intermittent claudication: the Framingham Study. J Am Geriatr Soc.. 1985;33:13-8.

Norgren L, Hiatt WR, Dormandy JA. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II).. Eur J Vasc Endovasc Surg.. 2007;33(^s1):S1-75.

Liapis CD, Tzortzis EA. Advances in the management of iliac artery occlusive disease: a short review. Vasc Endovascular Surg.. 2004;38:541-5.

Kolvenbach R. Total laparoscopic aortic aneurysm surgery. Acta Chir Belg.. 2006;106:36-9.

Lin JC, Kolvenbach R, Schwierz E, Wassiljew S. Total laparoscopic aortofemoral bypass as a routine procedure for the treatment of aortoiliac occlusive disease. Vascular.. 2005;13:80-3.

Cau J, Ricco JB, Corpataux JM. Laparoscopic aortic surgery: Techniques and results. J Vasc Surg.. 2008;48:37S-44S.

Yoshida R, Yoshida WB, Kolvenbach R. Cirurgia aortoilíaca videolaparoscópica para tratamento de isquemia crítica de membros: relato do primeiro caso no Brasil. J Vasc Bras.. 2009;8:364-70.

Dion YM, Thaveau F, Fearn SJ. Current modifications to totally laparoscopic “apron technique”. J Vasc Surg.. 2003;38:403-6.

Coggia M, Bourriez A, Javerliat I, Goeau-Brissonniere O. Totally laparoscopic aortobifemoral bypass: a new and simplified approach. Eur J Vasc Endovasc Surg.. 2002;24:274-5.

Yoshida WB, Bosco FA, Medeiros FATM, Rollo HA, Dalben IN. Lípides séricos como fator de risco para pacientes com doença arterial periférica. J Vasc Bras.. 2003;2:5-12.

Junior O, van Bellen B. Transperitoneal and retroperitoneal approach to the abdominal aorta: early results. J Vasc Bras.. 2004;3:331-8.

Johnson JN, McLoughlin GA, Wake PN, Helsby CR. Comparison of extraperitoneal and transperitoneal methods of aorto-iliac reconstruction.: Twenty years experience. J Cardiovasc Surg (Torino). 1986;27:561-4.

Kolvenbach R, Deling O, Schwierz E, Landers B. Reducing the operative trauma in aortoiliac reconstructions: a prospective study to evaluate the role of video-assisted vascular surgery. Eur J Vasc Endovasc Surg.. 1998;15:483-8.

Yoshida WB. Radicais livres na síndrome de isquemia e reperfusão. Cir Vasc Angiol.. 1996;12:82-95.

Dion YM, Griselli F, Douville Y, Langis P. Early and mid-term results of totally laparoscopic surgery for aortoiliac disease: lessons learned. Surg Laparosc Endosc Percutan Tech.. 2004;14:328-34.

Kolvenbach R, Yoshida R. Cirurgia Aórtica Videolaparoscópica. Doenças vasculares periféricas. 2008;1:859-86.

Yoshida R, Yoshida W, Kolvenbach R, Rollo H, Lorena S. Laparoscopic aortic surgery learning curve: experimental study in pigs. J Vasc Bras.. 2008;7:231-8.

Coggia M, Javerliat I, Di Centa I. Total laparoscopic versus conventional abdominal aortic aneurysm repair: a case-control study. J Vasc Surg.. 2005;42:906-10; discussion 911.

Fearn SJ, Thaveau F, Kolvenbach R, Dion YM. Minilaparotomy for aortoiliac aneurysmal disease: experience and review of the literature. Surg Laparosc Endosc Percutan Tech.. 2005;15:220-5.

Ferrari M, Adami D, Del Corso A. Laparoscopy-assisted abdominal aortic aneurysm repair: early and middle-term results of a consecutive series of 122 cases. J Vasc Surg.. 2006;43:695-700.

Kolvenbach R, Da Silva L, Deling O, Schwierz E. Video-assisted aortic surgery. J Am Coll Surg.. 2000;190:451-7.

Dion YM, Gracia CR, Estakhri M. Totally laparoscopic aortobifemoral bypass: a review of 10 patients. Surg Laparosc Endosc.. 1998;8:165-70.

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