title: Long-Term Outcomes of Surgical Treatment with In Situ Graft Reconstruction for Secondary Aorto-Enteric Fistula.
abstract: Objectives:The optimal surgical management for secondary aorto-enteric fistula (sAEF) is controversial. Here, we report the long-term outcomes of a surgical treatment with in situ graft reconstruction for sAEF that was performed at our hospital.Methods:Between 2009 and 2012, 10 consecutive patients (8 males, 2 females, mean age 75.9 years) with sAEF were surgically treated with in situ graft reconstruction. Perioperative and long-term outcomes were reviewed retrospectively by medical records.Results:Clinical manifestations, including gastrointestinal bleeding, shock, sepsis, and back and abdominal pain, were observed during the treatment of the patients. In all the cases, the fistula was found between the duodenum or small intestine and the graft anastomosis, the graft itself, or pseudoaneurysm. Total graft excision and in situ graft reconstruction with omental coverage and digestive tract reconstruction was performed for all cases. There were two operative deaths because of multiple organ dysfunction syndrome and sepsis. The other patients showed no sAEF related complications, such as graft infection, and were alive during the 54-month mean follow-up period (33-76 months).Conclusion:According to our study, the long-term outcomes of surgical treatment with in situ graft reconstruction for sAEF were considered satisfactory. (This article is a translation of Jpn J Vasc Surg 2016; 25: 1-6.).
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Goto
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Daijirou
authors.initials: D
authors.lastname: Akamatsu
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tsuchida
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Tajima
authors.affiliation: Division of Organ Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
authors.forename: Michihisa
authors.initials: M
authors.lastname: Umetsu
keywords: aorto-enteric fistula; graft infection; in situ reconstruction